Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Dec 2014
Review[Specific anaesthetic procedures for nasal and sinus surgery.]
In nasal and sinus surgery, the anaesthetist must share the operating field with the surgeon and take into account some patients' specific pathologies. Bleeding must be avoided by different means but the accurate gesture of the surgeon, added to the properties of the new anaesthetic drugs, may reduce the risk of this functional surgery.
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Ann Fr Anesth Reanim · Dec 2014
[Necrotizing fasciitis: Results of a survey on management practices in French-speaking intensive care units.]
Necrotizing fasciitis (NF) are rare and severe soft tissue infections associated with a high mortality rate. In order to assess the management of NF in French-speaking intensive care units (ICUs), we conducted a survey endorsed by the French Society of Anesthesia and Intensive Care (SFAR). ⋯ This survey illustrates the heterogeneous management of NF in French-speaking ICUs and points out several logistical aspects that should be improved to reduce the time to the first surgical debridement.
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Ann Fr Anesth Reanim · Dec 2014
Randomized Controlled Trial[Prevention of hypotension during spinal anesthesia for elective caesarean section: Coloading with HAE 130/0.4 vs normal saline solution.]
The aim of this study was to compare the efficacy of HES 130/0.4 coloading compared to normal saline solution for prevention of hypotension during spinal anesthesia for elective caesarean section. ⋯ HES 130/0.4 coload was more effective than normal saline solution to prevent hypotension following spinal anesthesia for elective cesarean section. HES 130/0.4 coload reduced the incidence, the duration of longest hypotension, the need for ephedrine and the adverse maternal effects.
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Anaesthetists often stand in the front line to manage postpartum neurological deficits, although epidural analgesia is rarely responsible for these complications. An epidural analgesia was performed to relieve pain during spontaneous labor in a 34-year-old parturient. An emergency C-section was subsequently required due to fetal heart rate abnormalities. ⋯ Epidural bleeding after labor epidural analgesia is a rare complication that may jeopardize the functional prognosis. It may be difficult in some cases to differentiate an upper plexus injury due to labor and delivery from a central epidural analgesia-related nerve root lesion. Fetal head compression at the pelvic brim may induce neurological deficits in several well-differentiated nervous territories, thus mimicking an anaesthetic-induced perimedullar radiculopathy.