[Perioperative management of patients with systemic scleroderma].

Systemic sclerosis (SSc) is an auto-immune disease characterized by vasculopathy and the combination of microangiopathy and tissue collagen deposit leading to skin, digestive, pulmonary, myocardial and renal injuries. These repercussions could be challenging for anesthesiologists and associated with difficulties in airway management, and occurrence of congestive right heart failure or acute kidney crisis. The aim of this review is to review the physiopathology and the progression of the SSc, as well as to provide a strategy of perioperative management of these patients.

Influence of pain on postoperative ventilatory disturbances. Management and expected benefits.

Abdominal surgery induces postoperative ventilatory dysfunction related to a combination of reflex diaphragmatic inhibition, respiratory muscle injury and pain. The role of pain is difficult to isolate from other components. Thoracic epidural analgesia using local anesthetics is able to partially reverse the diaphragmatic dysfunction.

[Prehabilitation. Preparing patients for surgery to improve functional recovery and reduce postoperative morbidity].

Objective: Prehabilitation consists in providing a repetitive physical exercise before surgery to improve the postoperative recovery course. This review aims to evaluate the feasibility and the expected benefits of prehabilitation on the postoperative recovery course and the reduction of the postoperative morbidity.

Data Sources: Data research has focused on English-language articles in the Medline database, published from 1989 to 2013.

[Cost analysis comparing single-use (Ambu® aScope™) and conventional reusable fiberoptic flexible scopes for difficult tracheal intubation].

Objective: Recommendations on difficult tracheal intubation constrain each surgical block to have a fiberscope available. Reusable fiberscope presents the problem of availability, the risk of non-conventional infections transmission and the cost. Single-use fiberscopes are presently available (Ambu® aScope™).

Cost-effectiveness analysis comparing epidural, patient-controlled intravenous morphine, and continuous wound infiltration for postoperative pain management after open abdominal surgery.

Background: Continuous wound infiltration (CWI), i.v. patient-controlled analgesia (i.