Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Feb 2012
[Factors associated with non-compliance to surgical antimicrobial prophylaxis guidelines during a prospective audit].
To assess physician compliance with guidelines for surgical antimicrobial prophylaxis practices and to identify factors associated with non-compliance. ⋯ This study confirmed previous findings on the impact of the type of surgery and the wound class contamination on the overall compliance rate. Furthermore, non-compliance was related to surgeon prescriptions. The compliance should be improved by specific measures after professional feedback.
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Ann Fr Anesth Reanim · Feb 2012
Case Reports[Anaesthetic management for caesarean delivery and acute myocardial infarction by spontaneous coronary dissection].
Myocardial infarction is rare during pregnancy and is associated with a high maternal and foetal mortality rate. We report the case of a 32-year-old woman at 38 weeks gestation who developed a myocardial infarction with spontaneous coronary dissection treated with coronary angioplasty and who needed an emergency caesarean section. We discuss the anaesthetic management of urgent caesarean section in this context.
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Ann Fr Anesth Reanim · Feb 2012
Case Reports[A new complication related to prolonged prone position: a masseter muscle haematoma].
We report a case of a 54-year-old man who underwent an prolonged spinal osteosynthesis complicated by a masseter muscle compressive ischaemia and haematoma in the early postoperative period. A special attention of the body compressive points in particular of the face, in association with an horseshoe's headstall, would have probably lead to avoid this complication in this risk factors patient.
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We report two cases of iliac bone surgery (repair of a symphysis disjunction and fixation of a fracture of the iliac ala) where TAP blocks were effective for postoperative analgesia. In the first case, we performed a bilateral block, and only a unilateral block in the second case. We discuss possible mechanisms to explain the efficacy of the TAP blocks in such surgeries. As for the femoral nerve block in major knee surgery, we think that blocking the parietal pain from skin and blocking parietal muscles contracture, can reduce postoperative pain in such surgeries.
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During pregnancy, the plasma concentration of factor VII increases to reach values during the third trimester that can be twice the normal values (N: 70% to 140%). Congenital factor VII deficiency is a rare condition which may lead to haemorrhage. We report the case of a patient with a congenital factor VII deficiency who presented with severe postpartum haemorrhage requiring resuscitation with blood transfusion and surgical haemostasis. We discuss the treatment of congenital factor VII deficiency and its anaesthetic management, as well as the hemorrhagic risk during pregnancy.