ANESTHESIOLOGIE REANIMATION HAITI (HUEH)

Background: A surgical scoring system, akin to the obstetrician's Apgar score, has been developed to assess postoperative risk. To date, evaluation of this scoring system has been limited to general and vascular services. The authors attempt to externally validate and expand the Surgical Apgar Score across a wide breadth of surgical subspecialties. Methods: Intraoperative data for 123,864 procedures including all surgical subspecialties were collected and associated with Surgical Apgar Scores (created by the summation of point values associated with the lowest mean arterial pressure, lowest heart rate, and estimated blood loss). Patients' death records were matched to the corresponding score, and logistic regression models were created in which mortality within 7, 30, and 90 days was regressed on the Apgar score. Results: Lower Surgical Apgar Scores were associated with an increased risk of death. The magnitude of this association varied by subspecialty. Some subspecialti...

This message is also available online Networking World Anesthesia Convention (NWAC 2012), April 24-28, 2012, Istanbul, Turkey Scientific News Updates! The NWAC 2012 scientific program is now updated with sessions and speakers. Check out the updated timetable and see who will be presenting before booking your space. Scientific Program with Speakers NOW OPEN! Workshop Registration NOW OPEN! ...

La mémorisation est un évènement indésirable rare (autour de 1 cas/1000 AG) mais toujours possible au cours d’une anesthésie générale, malgréles mesures de prévention qui doivent néanmoins être appliquées. Elle représente un traumatisme psychologique qui peut se chroniciser en syndromede stress post-traumatique, ou donner lieu à une plainte médicolégale. Elle est le plus souvent associée à un réveil peropératoire. Ce réveil est favorisé par la diminution des doses d’agent hypnotique, soit paraccident, soit en raison d’une mauvaise tolérance ce qui définit des populationsà risque. La curarisation ne favorise pas le réveil, mais empêche son diagnostic. La prévention repose sur la connaissance des concentrations de perte de conscienceet la gestion équilibrée de l’association hypnotique-morphinique, ajustéeà chaque individu par le monitoring de l’EEG. ARTICLE COMPLET

We were greatly interested in the recent article of Combes  et al. 1  that prospectively validated a prehospital difficult-intubation algorithm. In this clinical study, the tracheal intubation with direct laryngoscope proved impossible in 160 patients. However, of these 160 patients, 15 had a laryngeal view of the Cormack and Lehane (C&L) class I or II, which is generally regarded as an easy laryngoscopy. 2 The ease of direct laryngoscopy is not synonymous with ease of tracheal intubation, but the laryngeal view obtained by direct laryngoscopy usually is an important determinant of successful intubation. We would like to know the detailed cause of failed intubation in these patients with an easy laryngoscopy. Moreover, the authors did not clearly describe whether their algorithm required for use of an endotracheal tube with a malleable stylet at the initial intubation attempt. In managing difficult intubation, mounting the endotracheal tube onto a stylet and angling the ...