ANESTHESIOLOGIE REANIMATION HAITI (HUEH)

Patient position after spinal anesthesia has had variable effects on blood pressure and ephedrine requirements. The aim of this study was to determine the effects that sitting the patient up for five minutes after spinal anesthesia would have on intraoperative fluid and ephedrine requirements. METHODS: The study included 120 women at term gestation who were scheduled for Cesarean delivery under spinal anesthesia. After anesthetic administration, the women were randomized either to sit up for five minutes then lie down (Group S) or to lie down immediately (Group L) to a tilted supine position. A blinded observer recorded sensory block level, systolic blood pressure, heart rate, ephedrine and fluid requirements, adverse events, and time to motor recovery (modified Bromage score of 2). RESULTS: Group S had a lower intraoperative sensory block height than Group L [T4 (1) vs T2 (1), respectively; P < 0.001]; Group S also required

Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists Article complet

Dexamethasone is frequently administered in the perioperative period to reduce postoperative nausea and vomiting. In contrast, the analgesic effects of dexamethasone are not well defined. The authors performed a meta-analysis to evaluate the dose-dependent analgesic effects of perioperative dexamethasone. Article complet

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Our specialty has a high level of expertise with most aspects of airway management. Emergency Physicians have become experts at inserting an endotracheal tube (ET) for definitive control of the airway. However, very little training is given for the removal of the ET tube. Although extubation is commonly performed during peri-operative management, a search of the Emergency Medicine literature revealed no studies on extubation in the emergency department (ED). At some centers, ED extubation is routine, though the safety of this procedure has not been definitively established. Importance Intubation in the ED requires admission to a high-acuity bed and intensive monitoring by nurses and physicians during the entirety of the patient’s ED stay (1). If a subset of patients can have their endotracheal tube removed safely, it will allow admission to a lower-acuity bed or, in some cases, even discharge. This has the potential to save resources and decrease length of stay. CLIQUEZ

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