Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2006
Review[Perception and communication of medical risk which implications for preoperative anaesthetic consultations?].
Informing patients about available treatments, their advantages and disadvantages, as well as the associated risks, is critical to obtain an informed consent and is the responsibility of physicians, including anaesthesiologists. However, risks issues are not systematically discussed during anaesthesia consultations or are addressed in a vague and incomplete way. ⋯ This article is based on a review of French and English literature on perception and communication about medical risks. Its objectives are for the one hand to summarize the main difficulties concerning risk communication in medicine and, on the other hand, to offer tools that can foster quality communication with patients especially during anaesthesia consultations.
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Ann Fr Anesth Reanim · Jan 2006
Case Reports[Systemic toxicity with mepivacaine following axillary block in a patient with terminal kidney failure].
As onset time and duration of sensory block are intermediate, mepivacaine is widely used for regional anaesthesia. Few reports of systemic adverse effects are available following nerve blockade with mepivacaine. We report the case of a 54-year-old patient suffering from terminal renal failure who needs the confection of an arteriovenous shunt under axillary brachial plexus block. ⋯ The patient received midazolam and surgery was planned the following day under general anaesthesia. Plasma mepivacaine concentration at time of neurological signs was measured at 5.1 microg/ml. Prevention and treatment of systemic toxic effects after regional anaesthesia are discussed.
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Ann Fr Anesth Reanim · Jan 2006
[Pregnant woman anaesthetic management in gynaecologic laparoscopic surgery at the maternity hospital of Clermont-Ferrand].
To evaluate the anaesthetic management intended for pregnant women in the field of non obstetric and gynaecologic laparoscopic surgery. ⋯ Laparoscopic surgery during pregnancy requires double skilled management, both in anaesthesiology and obstetrics. On haemodynamics and breathing, pneumoperitoneum does not induce any additional effects when compared to operations without pregnancy. Except with delivery cases, anaesthetic support in laparoscopic surgery intended for pregnant women eventually does not generate any specific problems, but requires the same rigorous management as the one usually following surgery for pregnant patients.