Safety of day surgery for patients with special needs.

Background: The objective of this study was to assess the safety and quality of day care management for dental surgery under general anaesthesia in a population with special needs and to compare the results with a control population.

Methods: A retrospective observational cohort study was performed. The study population included all patients who had day care dental surgery under general anaesthesia for one year.

Bacterial colonization is decreased after tunneling femoral perineural catheters.

Background: Infection of perineural catheter is rare, although bacterial colonization is frequent. An observational study reported that subcutaneous tunneling perineural catheter could decrease its colonization rate. We performed a comparative study to assess the incidence of catheter related bacterial colonization of tunnelized femoral perineural catheters.

Residents in tutored practice exchange groups have better medical reasoning as measured by the script concordance test: A pilot study.

Background: This pilot study attempted to evaluate the impact of a practice exchange group (PEG) tutored by a senior anaesthesiologist on clinical reasoning performance of anaesthesiology residents for uncertain situations. Changes in clinical reasoning were measured by script concordance tests (SCT).

Methods: First, a curriculum, with educational objectives and assessment tools, was proposed to all residents at the beginning of their 6-month training.

[Evaluation of the impact of prescription analgesic during the anaesthesia consultation on the incidence of postoperative pain at home in ambulatory orthopaedic surgery].

Introduction: Postoperative pain at home in ambulatory surgery is a major problem. To improve its management, the French society of anaesthesia emphasizes the importance of writing prescriptions for analgesic during the preanaesthetic consultation. The objective of this study was to assess the impact of this prescription on the incidence of postoperative pain at home in ambulatory orthopaedic surgery.

Contribution of the anatomy laboratory to the practical training of residents in regional anesthesia.

Introduction: Dissection workshop has never been assessed in the initial training of resident medical students in anesthesia. This work aimed at assessing the impact of this educational tool on the rates of success of the main blocks the resident in anesthesia achieved during their training.

Materials And Methods: The primary outcome measure studied in this work was the self-assessment by the resident of the rate of success of every block before and after the complementary training in regional anesthesia included dissection workshop, determined by a questionnaire sent by post at least 6 months after the teaching.

[Acute respiratory distress subordinate to a morphine overdose during a frail elderly patient controlled analgesia].

We describe a case-report of an 85-year-male patient with a patient-controlled analgesia (PCA) after a total hip arthroplasty. Four hours after surgery, acute respiratory distress secondary to a morphine overdose occurred, requiring an antagonisation with naloxone. Morphine overdose during a PCA was always caused by a wrong use of the pump.

Bacterial colonization after tunneling in 402 perineural catheters: a prospective study.

Background: Bacterial colonization of peripheral nerve catheters is frequent, although infection is relatively rare. With central venous catheters, the tunneling of the catheter into the subcutaneous tissue significantly decreases catheter colonization and catheter-related sepsis. We evaluated the incidence of bacterial colonization in adult patients with tunnelized perineural nerve catheters.

Major complications after 400 continuous popliteal sciatic nerve blocks for post-operative analgesia.

Background: A continuous popliteal sciatic nerve block (CPSNB) has been performed with increasing frequency for post-operative analgesia after foot surgery. Major complications associated with the placement of a perineural catheter remain rarely studied. The aim of this study was to prospectively determine the incidence of major complications (neurological and infectious) in post-operative adult patients with a continuous popliteal catheter inserted by the anatomical posterior approach for analgesia after foot surgery.

The risk of pulmonary aspiration in patients after weight loss due to bariatric surgery.

Background: We conducted a study including patients with gastric banding or gastroplasty who previously underwent plastic or functional surgery to assess the risk of pulmonary aspiration.

Methods: A retrospective case-control study was performed including all patients undergoing a plastic or functional surgery over a 5-yr period (2000-2005) at Rouen University Hospital. Two groups were defined: the postbariatric group included patients who previously had bariatric surgery (laparoscopic adjustable gastric banding or Mason's vertical gastroplasty) before undergoing the plastic surgery; all other patients were assigned to the control group.

[Evaluation of postoperative analgesia with continuous iliofascial nerve sheath block after total hip arthroplasty replacement: a pilot study].

Objective: To assess the analgesic efficiency of a continuous iliofascial nerve sheath block after total hip arthroplasty replacement (RPTH).

Study Design: open and prospective pilot study.

Patients And Methods: Before induction of general anaesthesia (GA), an iliofascial catheter was inserted (group KT, n = 11) or not (group NKT, n = 10).

[Evaluation of continuous nerve block for postoperative pain management in orthopaedic surgery].

Objective: After orthopaedic surgery, continuous nerve block analgesia provides effective postoperative pain relief. The practical use of these techniques may present problems. The purpose of this study was to assess the development of continuous block procedure for postoperative pain based on quality standard management and the effectiveness of initial training as an adjunct for introduction of these techniques.

Thigh abscess as a complication of continuous popliteal sciatic nerve block.

We present a case report of severe localized infection after continuous popliteal sciatic nerve block. The report highlights the importance of meticulous asepsis and possibly limiting the duration of catheter use.