ANESTHESIOLOGIE REANIMATION HAITI (HUEH)

Background: Although predictors of laryngeal mask airway failure in adults have been elucidated, there remains a paucity of data regarding laryngeal mask airway failure in children. Methods: The authors performed a retrospective database review of all pediatric patients who received a laryngeal mask anesthetic at their institution from 2006 to 2010. Device brands were restricted to LMA Unique™ (Cardinal Health, Dublin, OH) and LMA Classic™ (LMA North America, San Diego, CA), and primary outcome was laryngeal mask failure, defined as any airway event requiring device removal and tracheal intubation. Potential risk factors were analyzed with both univariate and multivariate techniques and included medical history, physical examination, surgical, and anesthetic characteristics. Results: Of the 11,910 anesthesia cases performed in the study, 102 cases (0.86%) experienced laryngeal mask failure. Common presenting features of laryngeal mask failures included leak (25%), o...

Le Service d’Anesthésiologie et de Réanimation de l’HUEH vous présente ses plus cordiales salutations et profite de l’occasion pour vous inviter à la cérémonie de présentation des travaux de sortie des résidents finissants qui aura lieu le mercredi 28 mai a 8h30 am au local du CIFAS/HUEH. Trois présentations sont prévues :      1. « Le dossier anesthésique dans les hôpitaux universitaires. Vers l'informatisation. » (DR. FARAH FRANCK)      2. «  La rachianesthésie chez les bébés: une alternative à l'anesthésie générale et à la caudale. » (DR. PASCALE SEVERE) 3.   « Profil épidémiologique et prise en charge anesthésique du sujet hypertendu au service d'Anesthésiologie et de Réanimation de l’HUEH d'avril à octobre 2013. » (DR. BARBARA MATHURIN) En vous remerciant par avance de l'attention que vous accorderez à cette demande, le Service vous prie d'agréer, l'expression de sa considération disti...

Maintaining a patent airway following the induction of general anesthesia is undeniably the most imperative concern for an anesthesiologist. Unanticipated difficult intubation, especially when associated with difficult or lack of ventilation in anesthetized patients, is still the main cause of morbidity or mortality. 1 The incidence of difficult laryngoscopy or tracheal intubation was reported to be in the range of 0.1–20.2%; this variation is due to the different patient populations and criteria used. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Prediction of difficult intubation in preoperative evaluation has been attempted by numerous investigators using simple bedside physical examinations based on anatomical landmarks such as modified Mallampati test (MMP), interincisive distance, thyromental distance (TMD), sternomental distance, upper lip bite test, and hyomental distance ratio, 3 , 7 , 10 , 11 all of which have shown different sensitivities and specificities. In the auth...

Etomidate is a hypnotic drug widely used as an intravenous anesthetic induction agent. The incidence of etomidate-induced myoclonus has been reported as much as 50–80% after induction making it an undesirable drug for induction. SOURCE

The hypothalamic-pituitary-adrenal (HPA) axis is a neuro-endocrine system that regulates circulating levels of glucocorticoid hormones. These hormones are vital for normal homeostasis and play a pivotal role in the response to stress. Levels of cortisol fluctuate throughout the day in a diurnal rhythm, underlying which is an ultradian rhythm of approximately hourly pulses, and this pulsatility directly affects transcriptional outcomes. Pulsatility is not the result of a ‘pulse generator’, but is inherent within the system as a result of negative feedback. These patterns of secretion change in both acute and chronic illness as a result of inflammatory mediators, splanchnic nerve output, and central nervous system control. Levels of cortisol in both normal and illness states are highly dynamic and so previously us...

Management of the difficult airway remains one of the most relevant and challenging tasks for anesthesia care providers. This review focuses on several of the alternative airway management devices/techniques and their clinical applications, with particular emphasis on the difficult or failed airway. >>>>>>>>>>>>>>CONSULTEZ ARTICLE PDF

INFO-CHIR:La Revue Haitienne de Chirurgie et d’Anesthésiologie SOMMAIRE EDITORIAL ARTICLES MEDICAUX: 1. Dermato fibro sarcome géant Dr. Emmanuel Régis 5 2. Tumeurs à cellule géantes des gaines tendineuses du poignet révélée par un syndrome du canal carpien : à propos d’un cas Dr. H. Fahim 8 X TREME DIA : Bézoard Dr. Louis-Franck Télémaque 12 DIAPORAMA : Tumeur phyllode du sein Dr. Louis-Franck Télémaque 13 DOSSIERS : UROLOGIE, Le POINT ! 1- Histoire de l’Urologie en Haiti Dr. Pierre Boncy 14 2- Inventaire des ressources humaines en Urologie en Haiti Dr Claude Paultre 16 3- Pratique de la chirurgie urologique en privé à Port-au-Prince Dr Pierre Alix Nazon 17 4- Obstacles à la practice de l’Urologie en Haiti – Une analyse des besoins. Dr. Jean Jeto Dubé 20 5- Formation urologique en résidence hospitalière – Obstacles et limitations Dr. Jory Désir – Y Dreux 22 6- Stratégies pour améliorer la formation de base en Urologie in Haiti Dr. Ange...

In performing noncardiac surgery on patients on anticoagulation, the major concern is when it is safe to perform surgery without increasing the risk of hemorrhage or increasing the risk of thromboembolism (eg, venous, arterial) after discontinuing treatment. In treating patients on long-term warfarin (Coumadin) perioperatively, consider the risks of hemorrhage or thromboembolism versus the benefit from the operation. When considering noncardiac surgery, these factors and the need to weigh the risk of hemorrhage against that of thromboembolism must be analyzed on an individual patient basis. Certain procedures (eg, oncologic procedures, threats to limb or life) are easy analyses. More complex discussions must be had for such cases as hernia repair of other elective nonurgent operations. The approach options for these patients can be one of the following: continue warfarin therapy, withhold warfarin therapy for a period of time before and after the procedure, or temporar...

Fatigue is a state of physical or mental weariness characterized by a lessened capacity for work and a reduced efficiency of accomplishment. It may result from a period of intense or prolonged exertion or alternatively may occur after time spent on unchallenging or monotonous tasks. In clinical practice, it is associated with long hours of wakefulness, sustained mental effort, and shift working. Fatigue negatively affects performance and is associated with increased risks to patient safety and to the well-being of the anaesthetist. The increase in shift working for trainees as a consequence of the European Working Time Directive (EWTD) and the increasing likelihood of a 24-h consultant-delivered service have increased concerns that fatigue may become more prevalent in front-line anaesthetists with predictable implications for safety and clinical effectiveness. SOURCE

Anesthesia and surgery significantly increase the risk for dementia, new research suggests. A large population-based study conducted by investigators at the Neurological Institute in Taipei Veterans General Hospital, in Taipei City, Republic of China, showed that the risk of developing dementia nearly doubled within 3 to 7 years of anesthesia and surgery. In addition, the average time to dementia diagnosis was shorter in patients who had anesthesia and surgery compared with their counterparts who did not undergo these procedures. The study adds to "growing concerns that anesthetic agents may have neurodegenerative complications," study investigator Jong-Ling Fuh, MD, of the Neurological Institute, told Medscape Medical News . "In vitro and animal studies showed that inhaled anesthetic drugs can promote amyloid beta oligomerization and impair memory. However, it remains controversial whether anesthesia and surgery contribute to the development ...

  BONNE FETE DR. MAGDALA PAVRETTE (MDS) : 9 MAI

Despite forced-air warming, hypothermia is common and often prolonged in patients undergoing noncardiac surgery, researchers have found. The new study showed that patients who experienced temperatures below 35°C had significantly longer hospital stays and greater transfusion requirements. SOURCE  

Chewing gum proposal has been used in surgery to reduce postoperative ileus for more than 10 years; however, the efficacy remains imprecise. The aim of this study was to accurately assess whether the use of the chewing gum could reduce duration of postoperative ileus following the abdominal surgery. SOURCE