Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2012
Review[What should we do and what should we not do after an anaesthetic accident. The point of view of a medical expert].
Lawsuits following an anaesthetic accident are fortunately infrequent. Anaesthesiologists are mainly sued by parents when the accident led to death or permanent brain damage. The aims of this short review are to explain how the medical expert is chosen by the court, what are the goals of the mission given by the judge, and how to prepare the medical expertise.
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Ann Fr Anesth Reanim · Jan 2012
[Stability and compatibility of acetaminophen, ketoprofen and amoxicillin in a fail-safe intravenous administration set].
Intravenous infusion takes an important place in the current therapy in hospitals and pharmaceutical firms keep improving their infusion medical devices, particularly with the development of an intravenous administration set with an automatic infusion stop. The aim of our study consists in an evaluation of the stability of acetaminophen, ketoprofen and amoxicillin during infusion and stasis of drugs for several hours in the dropper chamber and in the tube of this device. ⋯ Despite the technical innovation of a fail-safe intravenous administration set, we have to stay aware of mixture consequences in intravenous infusion field.
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The activity of a paediatric chronic pain clinic is described. The author highlight the importance of the first visit of the child with its parents, and of a multidisciplinary approach adapted to the child's individual needs.
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Ann Fr Anesth Reanim · Jan 2012
Review[What to do or not, after an anaesthetic accident? The point of view of the medical advisor].
The objectives of this review are (1) to explain the goals of a medico-legal appraisement and describe the various jurisdictions able to order it; (2) to analyze the actions to be taken from the medico-legal point of view during and after the accident; (3) to give advise concerning communication with the patient, its family and the colleagues involved in the case; (4) to describe of the role of the medical advisor before (constitution of the file to communicate), during (assistance to the blamed practitioner) and after the expertise (to learn the practical lessons); (5) to recall the importance of the quality of the anaesthetic file, the keystone of the expertise, and the rules governing the responsibility for the doctor.
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Three types of hyperalgesia can occur during the postoperative period: primary hyperalgesia, which disappears with wound healing, secondary or central hyperalgesia, which can lead to chronic pain, and opiate-induced hyperalgesia. Different drugs, most of which are NMDA receptors antagonists, are used to decrease or prevent the risk of central or opiate-induced hyperalgesia. However, it is difficult to determine whether they are really effective and at which dosage: the results of most published studies are difficult to interpret because of methodological problems. The two most frequent of those are: absence of objective measurement of secondary hyperalgesia and difficulties targeting an at risk population.