Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2011
Review[Alzheimer's disease and anaesthesia: potential relationships and clinical implications].
Alzheimer's disease is the most common form of dementia. As the aging population increases, Alzheimer's disease is becoming a major concern of Public Health. ⋯ Large clinical studies are required to develop new strategies for perioperative management in such patients, including the adjustment of anaesthesia techniques. Before that, information of patient and its relatives and a particular attention for elderly during anaesthesia and perioperative period should be considered.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Obstructive hypertrophic cardiomyopathy and caesarean section under combined spinal and epidural anaesthesia with prophylactic vascular ligation: regarding a case].
We report the case of a caesarean section under combined spinal and epidural anaesthesia in a pregnant 32-year-old woman with an hypertrophic obstructive cardiomyopathy. In these patients, variations of the ventricular load conditions may induce a cardiac inefficacy. ⋯ The arterial ligation according to the technique of Tsirulnikov is an alternative that we reported. This technique is followed by a good obstetrical prognosis.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Bilateral catheter for continuous TAP block and postoperative pain relief after gynecologic surgery].
We describe the case of two patients who had undergone gynecologic surgery and in whom a continuous ropivacaine infusion was administered through a catheter placed on each abdominal side, using the technique of ultrasound-guided TAP block. Postoperative analgesia was of excellent quality with almost no morphine requirement. No side effects were encountered.
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Ann Fr Anesth Reanim · Jan 2011
Case Reports[Severe acute asthma: isoflurane administration via AnaConDa™, is it safe?].
Standard treatments against severe acute asthma can be insufficient and need salvation treatments, such as isoflurane delivery. These treatments have not been much assessed and could lead to unrecognized side-effects. We report the case of a young man who suffered from intracranial hypertension associated with severe hypercapnia during the delivery of isoflurane via the system AnaConDa™ or Anaesthetic Conserving Device™ (ACD) (Sedama Medical). The rising of PaCO(2) appears to be linked to an ACD-dependent increase in the dead space.
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The mistake-proofing concept often refers to physical devices that prevent actors from making a wrong action. In anaesthesiology, one immediately thinks to specific design of outlets for medical gases. More generally, the principle of mistake-proofing is to avoid an error, by placing knowledge in the world rather than knowledge in the head. ⋯ The mistake-proofing concept may be applied to prevention, detection, and mitigation of errors. The forcing functions are a specific part of mistake-proofing: they prevent a wrong action or they force a virtuous one. Grout proposes a little shortcut to identify mistake-proofing devices: "If it is not possible to picture it in action, it is probably not a mistake-proofing device".