[Paraumbilical block for strangulated umbilical hernia in emergency].

The authors describe a strangulated umbilical hernia surgery performed in emergency with a paraumbilical block associated with a local infiltration. For this patient, 3-4 ASA status, in occlusion, with iterative vomiting and coagulation disorders, general or spinal anaesthesia were high-risk technics. Paraumbilical block, sometimes used for anaesthesia or/and analgesia for programmed umbilical hernia surgery, allowed surgery with good conditions and procured prolonged postoperative analgesia.

[Postoperative pneumonia: nosocomial, predictable, iatrogenic, preventable or not?].

We report the case of a 52-year-old man, ASA 3-4, malnourished, heavy smoker and drinker at the stage of chronic obstructive pulmonary disease and cirrhosis. The postoperative course of a cervical cancer surgery was complicated by a pneumonia with fatal outcome in the intensive care unit. Taking into account the patient's history and surgical requirements, this nosocomial infection did not appear easily preventable.

[Orbital haemorrhage after medial canthus episclera (sub-Tenon's) anaesthesia].

Medial canthus episclera (sub-Tenon's) anaesthesia is a technique proposed as a suitable alternative to the more classical peribulbar block because of the greater reliability and more constancy in effectiveness. We report two cases of retrobulbar haematoma after sub-Tenon's anaesthesia, one with central retina artery compression needed anterior room punction. Sub-Tenon's anaesthesia, like peribulbar anaesthesia, can give also retrobulbar haemorrhage if the insertion of the needle is not limited to the anterior orbit.