Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2013
Major abdominal surgery for cancer: does epidural analgesia have a long-term effect on recurrence-free and overall survival?
Retrospective studies have suggested that regional analgesia combined with general anaesthesia could decrease cancer recurrence. The purpose of this study was to assess the influence of regional analgesia on recurrence-free (RFS) and overall survival in patients undergoing major intra-abdominal surgery for cancer. ⋯ Despite a trend in favour of the epidural, this retrospective review of patients included in a previous randomized study failed to demonstrate a statistically significant association between the perioperative analgesia and RFS after abdominal surgery for cancer. The duration of follow-up may have an impact on the analgesia effect on survival.
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Ann Fr Anesth Reanim · May 2013
Comparative Study[Cost analysis comparing single-use (Ambu® aScope™) and conventional reusable fiberoptic flexible scopes for difficult tracheal intubation].
Recommendations on difficult tracheal intubation constrain each surgical block to have a fiberscope available. Reusable fiberscope presents the problem of availability, the risk of non-conventional infections transmission and the cost. Single-use fiberscopes are presently available (Ambu® aScope™). This medico-economic study aims to assess the cost of using a reusable fiberscope as compared to the single use fiberscope. ⋯ This medico-economic evaluation shows that the utilization cost of single use and reusable fiberscopes are very close. This should be analyzed at the light of some benefits of using single use devices for the difficult tracheal intubation.
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Ann Fr Anesth Reanim · May 2013
Case Reports[Review of medication errors: a case in an intensive care unit].
The authors conducted for the first time a medication error review (REMED) following a medication error occurred in an intensive care unit. The aim of this study was to assess this first REMED. ⋯ The educational aspect of the REMED was clearly appreciated by all the different health care workers who participated to the analysis. Even if medication errors may occur at the different steps of the medication process, the REMED is a very good tool to improve the care quality and also to reduce the drug iatrogenic risk.
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Ann Fr Anesth Reanim · May 2013
Case Reports[Parkes-Weber syndrome and pregnancy: anaesthetic implications].
We report two deliveries in a patient with a Parkes-Weber syndrome. This parturient had a complex angiodysplasia including a soft tissue hypertrophy of a lower limb, a cutaneous angioma and arteriovenous malformations. The risk of perimedullar arteriovenous malformations was ruled out by angiographic magnetic resonance imaging of the spinal cord. We also describe other aspects of the management, including prepartum cardiovascular assessment, mode of delivery, the use of epidural analgesia and the prevention of haemorrhagia and thromboembolism.
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Traumatic neurogenic shock is a rare but serious complication of spinal cord injury. It associates bradycardia and hypotension caused by a medullary trauma. It is life-threatening for the patient and it aggravates the neurological deficit. ⋯ Steroids are not recommended. Early decompression is recommended for incomplete deficit seen in the first 6 hours. We relate the case of secondary spinal shock to a luxation C6/C7 treated in prehospital care.