Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jun 2013
Comparative Study[Opioid-sparing effect of ketamine during tonsillectomy in children].
In the adult population, Ketamine is currently used as an antihyperalgesic and opioid-sparing agent during the perioperative period. However, for doses of ketamine up to 0.5mg/kg, these effects have not been found in pediatric population. The aim of the present study was to evaluate the efficacy of a preoperative bolus of 1mg/kg of ketamine on postoperative pain intensity and morphine consumption in children undergoing tonsillectomy. ⋯ These results suggest that 1mg/kg of ketamine administered right after anaesthesia induction in children undergoing tonsillectomy did not result in an opioid sparing effect.
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Ann Fr Anesth Reanim · Jun 2013
[Assessment of practices in postoperative analgesia in caesarean before and after implementation of an information program].
To assess the improvement of practices in postoperative analgesia after a cesarean section post implementation of a corrective program. ⋯ After an awareness campaign of the paramedical and medical staff, we succeeded in improving significantly the routine use of analgesics regardless of their level. Nevertheless healthcare professionals still seem reluctant to administer opioids.
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Complications at extubation remain an important risk factor in anaesthesia. Airway related complications at extubation are relatively frequent but are usually dealt with by simple basic measures. We report a new case of respiratory complications associated with tracheal extubation in a 59-year-old woman. ⋯ Both tests showed a large thyroid "goitre plongeant" (plunging goiter) and compressive. In the suites, a thyroidectomy was performed with excision of a large cervical plunging goiter para- and retropharyngeal bilateral chest, allowing extubation successfully. The postoperative course was uneventful.
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Ann Fr Anesth Reanim · Jun 2013
[Need for integration and working conditions of locum anaesthesiologists in community hospitals of a French administrative area].
To evaluate the need for locum anaesthetic coverage and the practical consequences (integration, working conditions, quality and safety) arising during the first 5 days of work, when a temporary position is accepted. MEASURED PARAMETERS: 1) Telephone enquiry of administrative services of community hospitals (CH) in one French administrative area (Rhône-Alpes) about their need for locum anaesthetists; 2) if a position was offered, it was accepted when the participation to on-call duties was delayed after the first 5 days of work; 3) during the working period, the following characteristics were assessed: integration of the locum anesthesiologist among team members, comparison of practice patterns to national guidelines; 4) data from the Platines-website of the French Ministry of Health were used to quantify indicators of activity and size of the hospitals and search for correlations between these parameters and working conditions of the locum anaesthetist. ⋯ Temporary work force in anaesthesia is widely required in CH of the Rhône-Alpes area but this practice had not been formalised. No recruitment strategy was observable. This questions about the institutions' requirements for anaesthetic services in French public hospitals.