A prospective comparison of WALANT technique and general anesthesia in forefoot surgery.

Introduction: Wide Awake Local Anesthesia No Tourniquet (WALANT) technique has been widely used in hand surgery, but there are few prospective data on its use in forefoot surgery.

Hypothesis: The WALANT technique reduces pain compared to general anesthesia for bone surgery on the first ray of forefoot.

Methods: This was a prospective, longitudinal, comparative, non-randomized cohort study in adult patients undergoing bone surgery on the first ray of forefoot.

[Comparison of 2 administration protocols (continuous or discontinuous) of a time-dependent antibiotic, Tazocin].

A predictive parameter of beta-lactam therapeutic efficacy is the time (T > MIC) while antibiotic serum concentrations are above the MIC of suspected bacteriological agents. This led us to carry out a randomised open study to compare the usually used intermittent administration of Tazocin (three injections of 4 g/0.5 g a day) and continuous perfusion of 12 g/1.

[Use of the colonization index].

In a retrospective study, 2,238 mycologic samples obtained in 1999 from 89 patients hospitalised in an intensive care unit dedicated to digestive diseases were analysed. Feasibility of monitoring fungal colonisation and implications for workload and costs were assessed. From this experience, we confirmed the ability of the Pittet index to identify patients at high risk for Candida infection.

[Postoperative encephalopathies: thiamine deficiency, an unrecognized etiology].

We report the case of a patient who experienced a postoperative Wernicke encephalopathy 8 days after a left hepatectomy performed for metastasis related to a rectal cancer. During the six months before surgery the patient lost 10 kg of weight (15%). Moreover, in the postoperative period the patient received exclusively 5% dextrose solution intravenously.