共查询到20条相似文献,搜索用时 15 毫秒
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Objective
This review discusses variability among patients in anesthesia, due to genetic polymorphisms.Data sources
Articles in French and English languages were retrieved from PubMed database. The initial request was “anesth* and (genotyp* or polymorphism* or genetic*)”.Study selection
Original articles, general reviews and one case report. Letters were excluded.Data extraction
Rare genetic diseases were excluded from the scope of this review. We stressed on frequent genetic polymorphisms that may have a daily impact in anesthesiology.Data synthesis
Most results were related to pain studies. We selected various examples to describe how genetic polymorphisms impacts the pharmacology of a given drug, and what are the clinical consequences.Conclusion
There is a growing field of pharmacogenetic related evidences in anesthesiology. The results from various animal and human studies underline the genetic origin of variability among individuals. How anaesthesists have to integrate these parameters for their daily practice is still unclear, but pharmacogenetic will obviously be a leading field of anesthesia research in the future. 相似文献8.
The authors describe the way pediatric anesthesia is organized outside the operating theatre in their country. In Germany, children can be anesthetized outside the operating theater in the hospital but also outside the hospital according to the concept of office-based anesthesia. National recommendations have been published and their revision is currently underway. In Quebec, pediatric anesthesia outside the operating theatre are well organized in order to ensure quality of care, patient's safety and efficiency of the system. 相似文献
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The goals of this review are to recall some pathophysiological principles at work in most of congenital heart diseases; to specify factors to be considered when defining perioperative risk for a child with an acquired or congenital heart disease; to describe an anaesthetic management strategy in the context of some specific heart diseases. 相似文献
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G. Lacroix E. Meaudre B. Prunet T. Guerin M. Allary E. Kaiser 《Annales fran?aises d'anesthèsie et de rèanimation》2010
Objective
Defining the place of regional anaesthesia (RA) for facial wounds in an emergency department.Study Design
Prospective observational study conducted in the emergency department of a regional hospital.Patients and methods
Two hundred and forty-six successive patients with one or more facial wounds were included from 1st august 2004 to 31st december 2004. Data on patient, operator, wound (measured by the number of stitches), anaesthetic method (RA, local anaesthesia [LA], or no anaesthesia), method of repairing skin, duration of intervention, operator comfort (verbal numeric scale [VNS] from 0 to 10) and pain feeled by the patient (visual analogic scale [VAS] from 0 to 10) in the different stages of care were collected.Results
Compared to the LA, the RA of the face decreased the number of punctures (1.36 vs 4.38 punctures, p < 0.001) and the quantity of local anaesthetic injected (2.8 ml vs 5.3 ml, p < 0.01) for wounds requiring more than 10 stitches. It has improved operator comfort (VNS = 10 [8–10] vs 8 [6.75–10] (p < 0.01)). Its effectiveness during skin repair was equivalent to that of the LA by infiltration (VAS 0 [0–1] vs 0 [0–1]).Conclusion
When practicable, the RA of the face is a better technique than the LA for facial wounds treatment. 相似文献13.
T. Gros P. Amaru C. Basuko S. Dareau J.J. Eledjam 《Annales fran?aises d'anesthèsie et de rèanimation》2010
Objectives
Evaluate the analgesic efficiency of the sciatic nerve block in prehospital care at the time of some severe legs or feet traumas.Patients and methods
Retrospective, monocentric study upon a period of time 1998–2008.Results
Twenty-three sciatic nerve blocks have been colligated, five by upper way and heighten by lateral popliteal lower way among which fourteen without neurostimulator. The pain decrease evaluated by the EVS at T0 (before block), T1 (10 min after block) and T2 (arriving in emergency department), has been significative, whatever the measure time interval (T0–T1, T0–T2, T1–T2), the ways used and the local anaesthetics given. The analgesia installation was faster when approaching the sciatic nerve block by the upper way and when using a neurostimulator. Only one analgesic failure was observed while doing a lateral popliteal way without neurostimulator. Any complication was reported.Conclusion
The sciatic nerve block done in prehospital shows a significant analgesic efficiency which would worth a deeper evaluation and a thought on its introduction in the ED physician's therapeutic gear. 相似文献14.
This short review is aimed at describing the particularities of consent in paediatric patients. For routine procedures, the consent of one of the parents is required whereas both parents should sign the consent for research protocols. In case of difficulties such as Jehovah witnesses or parental opposite opinions, doctors should ask the question to the judge in charge of protection of children. Consent or at least assent of minors enrolled in research protocols should be obtained provided their maturity is sufficient to understand correctly the purpose of clinical research. 相似文献
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To assess safety and efficacy of tumescent infiltration of the supraclavicular nerve and the anterior and lateral branches of the intercostal nerves in major breast surgery.Methods
A retrospective analysis of six selected patients undergoing mastectomy was performed. A mixture composed of 150 mg ropivacaine, 400 mg of lidocaine and 0.5 mg epinephrine diluted in 500 ml Ringer's were administered subcutaneously as follows: 80 ml along the parasternal line from the second to the sixth intercostal space, 80 ml along the mid axillary line from the second to the sixth intercostal space, 80 ml along the infraclavicular line, 80 ml in the space between the pectoralis muscle and the mammary gland and 80 ml in the axilla in case of axillary dissection.Results
This technique achieved effective analgesia in six patients associated with sedation or light anaesthesia; conversion to general anaesthesia or supplementation with local anaesthesia was not required. No complication was observed. No emesis was noted.Conclusion
This technique provides adequate peroperative analgesia and is a technically low-risk procedure. Further evaluation of this technique is recommended. 相似文献16.
A patient presenting with paramyotonia congenita (Eulenburg's paramyotonia) was seen at the preanaesthetic visit during pregnancy. The underlying disease was known for years. Analysis of the literature and advice taken from specialists emphasized the safe use of regional anaesthesia and analgesia which was indeed used for labour and delivery without any complication. By contrast, the limited information available on the use of general anaesthesia suggests the risks associated with the use of succinylcholine and possibly with halogenated agents. Additional and useful factors that may limit the occurrence of myotonic crises such as maintenance of normal temperature and plasma potassium concentration, should be undertaken simultaneously. 相似文献
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A. Thevenin V. Chenet S. Schlumberger M. Fischler 《Annales fran?aises d'anesthèsie et de rèanimation》2009
Objectives
This article summarizes functioning and results of anaesthesia adverse effects reporting system over its first 18 months, from August 2006 to February 2008.Study design
Monocentric retrospective study.Methods
Reporting system is available 24/24 h, 7/7 to every employee with an individual password. A committee with anaesthesiologists, nurses and risk management engineer examines every notification by two months. We evaluated number of reports, type of reporter, type of dysfunction reported and solutions. Numerical data are compared with a Student t test or X2 test. A p-value of less than 0.05 g being considered as statistically significant.Results
One hundred and eighty-five reports were registered for the first 18 months (1% of anesthesia activity) with a slowdown with time (p = 0.02). Eighty-six percent of the statements were made by anesthesiologists, but some physicians had never reported. Malfunctions shared between different services (identity, operating room organisation) are rarely solved (67%) compared to specific anesthesia problems (93%) (p < 0.001).Conclusion
The reporting system is simple and available but some professionals don’t declare, generating reporting bias. This network underlines major general dysfunctions (identity) but ways to solve are limited to date. 相似文献19.
E.P. de Souza Neto S. Grousson F. Duflo S. Gandreau D. Rousson C. Cornu C. Mottolese J.-C. Froment F. Dailler 《Annales fran?aises d'anesthèsie et de rèanimation》2010