Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2010
Review[Obstructive sleep-apnoea syndrome in adult and its perioperative management].
Obstructive sleep apnoea (OSA) syndrome in adult is defined as an Apnoea-Hypopnoea Index (AHI) of 5 or more per hour of sleep in a context of excessive daytime sleepiness and snoring. OSA is considered as mild with an AHI of 5-15, moderate with an AHI of 15-30, and severe with an AHI greater than 30. OSA is a highly prevalent disease since it should affect 7-15% of the middle-aged population, but most patients are not yet diagnosed for OSA. ⋯ In the postoperative period, early resuming continuous positive airway pressure and installing the OSA patient in a nonsupine position could be effective in preventing pharyngeal obstruction. Considering the timing of postoperative complications, a careful monitoring in the post-anesthesia care unit for three hours is an appropriate strategy for a majority of OSA patients. Alternatives to opioids should be promoted for postoperative pain control.
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Ann Fr Anesth Reanim · Nov 2010
[Ultrasound-guided interscalene block: Influence of anatomic variations in clinical practice].
This study aimed to evaluate visibility of interscalenic brachial plexus (IBP) variations with ultrasonography (US). Secondary end-point compared success rate of the interscalene block (IB) in shoulder surgery with or without the presence of variation. ⋯ The high-resolution cervical US highlights the IBP variations. These variations appear not to have any relevant influence on the performance of the single shot IB.
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Ann Fr Anesth Reanim · Nov 2010
Randomized Controlled Trial[Anxiety: an independent factor of axillary brachial plexus block failure?].
To evaluate the impact of the anxiety level using Spielberger test on axillary block success. ⋯ Patient's anxiety level before axillary brachial plexus block is a risk factor of failure, especially in emergency condition. We suggest anesthesiologists to evaluate patient anxiety prior to block performance. A specific anxiolytic treatment may be recommend in some cases.