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Publications in this journal

• [Complication of a continuous popliteal sciatic nerve block.]

  Authors: C Landy, A Polycarpe, P Boulland, J-C Favier, D Plancade

  Annales francaises d'anesthesie et de reanimation.

• [Use of the validated reference tool of the French National Health Authority to evaluate postoperative pain management through 7 years: What are the key lessons?]

  Authors: M Binhas, F Roudot-Thoraval, A Alves, C Défendini, G Silvestre, J Marty, G D'Honneur

  Annales francaises d'anesthesie et de reanimation.

• [Pulmonary hypertension and femoral neck fracture: Interest of continuous spinal anaesthesia.]

  Authors: J Turc, A Lamblin, F Klack, P-F Wey, J-Y Martinez

  Annales francaises d'anesthesie et de reanimation.

  Anaesthetic management of patients with pulmonary hypertension is challenging and alternatives to general anaesthesia are encouraged. We report anaesthetic management of two patients with pulmonaryAnaesthetic management of patients with pulmonary hypertension is challenging and alternatives to general anaesthesia are encouraged. We report anaesthetic management of two patients with pulmonary hypertension admitted for femoral neck fracture. In order to reduce the risk of right-sided heart failure and systemic hypotension, it was decided to operate the patients under continuous spinal anaesthesia. Anaesthesia was induced with excellent hemodynamic tolerance. Quality and extension of the block was correct and allowed surgery. No postoperative complication was observed. These cases suggest that continuous spinal anaesthesia may be considered for the management of patients with pulmonary hypertension undergoing femoral neck fracture surgery.

• [Experience on the use of sugammadex in a French university hospital.]

  Authors: K Beny, A-F Mirabaud, V Piriou, G Aulagner, X Armoiry

  Annales francaises d'anesthesie et de reanimation.

• [Anaesthetic management of brain-dead for organ donation: impact on delayed graft function after kidney transplantation.]

  Authors: C Boutin, F Vachiéry-Lahaye, S Alonso, G Louart, A Bouju, S Lazarovici, P-F Perrigault, X Capdevila, S Jaber, P Colson, O Jonquet, J Ripart, J-Y Lefrant, L Muller

  Annales francaises d'anesthesie et de reanimation.

  BACKGROUND: The aim of this study was to report current anaesthetic management brain-dead organ donors and to assess its impact on delayed kidney graft function (DGF). METHODS: To achieve thisBACKGROUND: The aim of this study was to report current anaesthetic management brain-dead organ donors and to assess its impact on delayed kidney graft function (DGF). METHODS: To achieve this retrospective multicenter study, brain-dead patient records were analysed for the years 2005 to 2007. Expanded donor criteria, length of stay in ICU, duration of brain death, respect of recommended cold ischemia time, preoperative and intraoperative management, type of anaesthesia, hemodynamic and respiratory parameters during organ retrieval, and impact of anaesthesia on DGF were analysed. RESULTS: One hundred and forty-nine out of 165 files were available. Sixty-two percent of donors received anaesthetic drugs. There were no differences in demographic characteristics between the anaesthesia group (group A) and the no-anaesthesia group (group NA). In group NA, the mean arterial pressure (MAP)>65mmHg was more frequent (53% vs. 29%, P<0.01), but did not differ for maximal MAP. In group A, maximal heart rate was higher (120 vs. 105b/min, P=0.02) and donors received significantly more colloids (P<0.01). Independent risk factors of DGF included absence of hydroxyethyl starch infusion during the preoperative period and mechanical ventilation without PEEP. CONCLUSION: During organ retrieval, 62% of organ donors received anaesthetic drugs. Use of anaesthesia lead to lower MAP requiring more fluid challenge with colloids but did not influence the DGF.

• [Medication error: Account the shape but the context too.]

  Authors: V Minville, S Ruiz, F Ferre, C Gris, M-N Girbet

  Annales francaises d'anesthesie et de reanimation.

• [Coronary artery dissection complicated by myocardial infarction in a head trauma patient.]

  Authors: Y Hamonic, M Biais, D Naibo, P Revel, F Sztark

  Annales francaises d'anesthesie et de reanimation.

  Acute myocardial infarction, following coronary artery dissection, is a rare, but potentially fatal, syndrome after blunt chest trauma. The treatment is more complicated when intracerebral lesionsAcute myocardial infarction, following coronary artery dissection, is a rare, but potentially fatal, syndrome after blunt chest trauma. The treatment is more complicated when intracerebral lesions are present, because of the need of anticoagulation. We report the case of a 37-year-old male patient, suffering from a polytraumatism with intracranial petechial haemorrhages who have a left coronary artery dissection with acute myocardial infarction.

• [Wernicke's encephalopathy complicating hyperemesis gravidarum.]

  Authors: B Housni, A Mimouni, K Serraj, N Oulali, A Azzouzi

  Annales francaises d'anesthesie et de reanimation.

• [Prediction of fluid responsiveness: A new step towards a totally non invasive assessment.]

  Authors: B Tavernier, A Ouattara

  Annales francaises d'anesthesie et de reanimation.

• [Tracheal tube obstruction mimicking a bronchospasm.]

  Authors: P Hugot, D Aguillon, H Musellec, D Breitel, M Gentili

  Annales francaises d'anesthesie et de reanimation.

• [Change: Today or tomorrow.]

  Authors: C Jayr, A Albi-Feldzer

  Annales francaises d'anesthesie et de reanimation.

• [A 10, 000km long airborne medical evacuation of a patient under ECLS.]

  Authors: V Roy, J Jabot, B Bouchet, J-F Delambre, D Vandroux

  Annales francaises d'anesthesie et de reanimation.

• [Sudden death caused by a less lethal weapon chest-wall injury (Commotio cordis).]

  Authors: C Contargyris, E Peytel

  Annales francaises d'anesthesie et de reanimation.

  Less lethal weapons, like Flashball(®), are more and more used since 1995 in law enforcement, even by the local police to neutralize combative individuals and to disperse riot crowds. This gun firesLess lethal weapons, like Flashball(®), are more and more used since 1995 in law enforcement, even by the local police to neutralize combative individuals and to disperse riot crowds. This gun fires large rubber bullets and has been incriminated many times in cases of face injuries with functional consequences. In this case report, we mention a case of sudden death from cardiac arrest due to low energy chest wall impact of a rubber bullet shot with the Flashball. Commotio cordis is potentialized by a lethal set of three including, a certain impact velocity, an exact location of the hit over the cardiac silhouette, and a precise timing 15 m/s prior to the peak of the T-wave. This case report highlights the fact that such impacts can cause significant injury to internal organs, in particular circonstances, implying the necessity of a raising awareness of the medical staff, in ordre to not underestimate the severity of such injuries.

• [Conn adenoma complicated by tetraparesia.]

  Authors: M Bensghir, A Houba, R Ahtil, H Azendour, N Drissi Kamili

  Annales francaises d'anesthesie et de reanimation.

• [Videolaryngoscopy, for everybody?]

  Authors: R Martin, M-J Colas

  Annales francaises d'anesthesie et de reanimation.

• [Nutritional assessment of patients before surgery.]

  Authors: D Francon, C Chambrier, F Sztark

  Annales francaises d'anesthesie et de reanimation.

  The identification of nutritional status is one of the objectives of the anaesthesia consultation often difficult to achieve routinely. It usually requires the use of multiple indicators, which areThe identification of nutritional status is one of the objectives of the anaesthesia consultation often difficult to achieve routinely. It usually requires the use of multiple indicators, which are complex for a non-nutrition specialist. In preoperative period, nutritional assessment should be easy to do in order to identify patients who are malnourished or at risk of malnutrition and relevant information about nutritional risk should be registered in the patient chart. To facilitate this evaluation, we propose a stratification of nutritional risk in four grades (NG) using three types of simple and validated parameters: preoperative nutritional status (BMI, weight loss, eventually serum albumin), comorbidities and kind of surgery. This stratification can develop a tailored nutritional care for each patient.

• [Two cases of autoimmune encephalitis with antibodies to N-methyl-D-aspartate receptor in intensive care.]

  Authors: K Mataam, J-C Ilboudo, L Gazaigne, E Wafo, F Angenard

  Annales francaises d'anesthesie et de reanimation.

  We report here two cases of autoimmune encephalitis associated with antibodies against the N-methyl-D-aspartate receptor. The primary cause was an ovarian teratoma in one case. The outcomes wereWe report here two cases of autoimmune encephalitis associated with antibodies against the N-methyl-D-aspartate receptor. The primary cause was an ovarian teratoma in one case. The outcomes were good. The first case was a late diagnosis, despite a typical clinical presentation. The clinical presentation of this disease remains unknown, especially in the intensive care unit. The treatment was recently codified and transformed the prognosis of this encephalitis. The second case was early treated in the course of the disease, due to the experience related to the previous case. In case of unexplained acute or subacute encephalitis or psychiatric-like disorders without prior medical history, the determination of the level of expression of antibodies against the N-methyl-D-aspartate receptors and other antineuroreceptors antibodies can help to identify this diagnosis. The initial picture of the disease, its variability and the unawareness of the recent reports on this encephalitis may lead to a wrong diagnosis and inappropriate management.

• [Acute negative pressure pulmonary edema: Illustration from a unusual clinical case following a postoperative recurrent laryngeal nerve palsy.]

  Authors: Y Aissaoui, H Kichna, M Boughalem, N Drissi Kamili

  Annales francaises d'anesthesie et de reanimation.

  Acute postoperative negative pressure pulmonary edema (NPPE) is a respiratory complication due to upper airway obstruction occurring most commonly in the postoperative period. Pathophysiologically,Acute postoperative negative pressure pulmonary edema (NPPE) is a respiratory complication due to upper airway obstruction occurring most commonly in the postoperative period. Pathophysiologically, NPPE is explained by the abrupt generation of highly negative intrathoracic pressure that lead to fluid transudation from the pulmonary capillaries. This observation reports an unusual case of a young patient who has undergone total thyroidectomy for multinodular goiter. The postoperative period was marked by the occurrence of bilateral recurrent laryngeal nerve palsy that was complicated by a NPPE. The outcome was favorable after mechanical ventilation with reversal of NPPE and recovery of the recurrent laryngeal nerve function. This article stresses the importance of prevention of recurrent nerve palsy during thyroid surgery. It also highlights a little known respiratory complication: the NPPE. Understanding the pathophysiology of NPPE, rapid diagnosis and appropriate therapeutic measures could prevent its potential lethal consequences.

• [Announce a death rapes to the close relations in emergency situation and taken care.]

  Authors: H Romano, A Aurore, C Chollet-Xemard, J Marty

  Annales francaises d'anesthesie et de reanimation.

  The death is a part of the everyday life of the emergency medical teams, but to announce the death and to take care in immediate of the saddened close relations rest a testing experience for whichThe death is a part of the everyday life of the emergency medical teams, but to announce the death and to take care in immediate of the saddened close relations rest a testing experience for which the professionals of the emergency care are not still prepared. Our comment aims from the experience of care of families, saddened in immediate and also recorded within the framework of a specialized consultation, to pass on what the saddened persons can feel during the intervention of the help and the confrontation in the death of their close. Our objective being to bring to the professionals of the tracks of reflection to limit the risks of survictimisation.

• [Extensive mesenteric ischemia related to naratriptan overuse associated with grapefruit juice absorption.]

  Authors: S Gergaud, E Lermite, F Butel, C Soltner, S Lasocki

  Annales francaises d'anesthesie et de reanimation.

  We reported the case of a 61-year-old woman, who has been hospitalized in ICU because of an extensive mesenteric ischaemia, involving the small bowel, secondary to a naratriptan overuse. ThisWe reported the case of a 61-year-old woman, who has been hospitalized in ICU because of an extensive mesenteric ischaemia, involving the small bowel, secondary to a naratriptan overuse. This mesenteric ischaemia was complicated by multiple organ failure and was responsible for extensive small bowel resection and left colectomy. A concomitant abundant absorption of grapefruit juice, a well-known P450 inhibitor, may have enhanced this naratriptan toxicity. This case underscore that an abdominal pain occurring in the context of headache treatment may be related to a mesenteric ischaemia.

• [Internal jugular venous cannulation: What is the best approach?]

  Authors: T Lamkinsi, A Kettani, Z Belkhadir, J Tadili, M Y Benjelloun, A Mosadik, S Ahid, M Faroudy

  Annales francaises d'anesthesie et de reanimation.

  OBJECTIVES: The aim of this study was to compare two approaches used for internal jugular venous cannulation: the anterior way, described by English et al. and the posterior way, described byOBJECTIVES: The aim of this study was to compare two approaches used for internal jugular venous cannulation: the anterior way, described by English et al. and the posterior way, described by Jernigan et al. The primary endpoint was the rate of success. The secondary endpoints were the related adverse events and the difficulty factors. STUDY DESIGN: Prospective, randomized open clinical trial. PATIENTS AND METHODS: The study took place in the vital emergency room, the operating room and the emergency intensive care unit of Ibn Sina University hospital (Rabat, Morocco), between June and September 2010. Hundred and one patients needing a central venous catheter were randomized to undergo one of the two techniques. We compared: demographics, success rates, number of attempts, difficulty factors and adverse events. RESULTS: The success rate was significantly higher in the posterior group (96% versus 68%, P<0.001), with fewer attempts (1.3±0.7 versus 2.1±1.3; P<0.001). There were less pneumothorax, (0 versus 6%) and more accidental arterial punctures (34 versus 25.5%) in the posterior group, but the difference wasn't significant. Finally, none of the difficulty factors were correlated to the failure rate. CONCLUSION: This study shows that the posterior approach in internal jugular venous cannulation is more efficient than and as safe as the anterior approach.

• [Prospective trial comparing Airtraq™ and Glidescope™ techniques for intubation of obese patients.]

  Authors: L Putz, G Dangelser, B Constant, J Jamart, E Collard, M Maes, A Mayné

  Annales francaises d'anesthesie et de reanimation.

  OBJECTIVES: Videolaryngoscope techniques are more and more in use and tend to modify our approach for patients difficult to intubate. We compared two techniques, Airtraq™ and Glidescope™ with directOBJECTIVES: Videolaryngoscope techniques are more and more in use and tend to modify our approach for patients difficult to intubate. We compared two techniques, Airtraq™ and Glidescope™ with direct laryngoscopy, with special emphasis on ease of access to airway (Intubation Difficulty Score - IDS score, duration and success of intubation) and the impact on hemodynamic variables among patients with a BMI of more than 30. STUDY DESIGN: Prospective study randomised with minimisation technique. MATERIAL AND METHODS: Eighty patients have been allocated by minimisation to four groups: two groups being intubated with Airtraq™, each one with a different investigator, and two with Glidescope™ videolaryngoscope technique. Induction of anesthesia was standardly performed with total intravenous anesthesia with remifentanil, propofol in TCI mode and rocuronium in bolus. Following parameters were recorded : intubation success based on intubation time and desaturation level, its duration, its impact on hemodynamic variables, IDS score and possible dental lesions. RESULTS: Intubation success was 100% for Glidescope™ and 80.6% for Airtraq™ (P=0.009). Airtraq™ allowed a better visualisation of the vocal cords (lower Cormack and Lehane score) than Glidescope™. In contrast, alternative intubation techniques were significantly more often used in the Airtraq™ group. No difference could be detected between both systems on hemodynamic parameters. CONCLUSIONS: In obese patients, Glidescope™ allows intubation relatively easily without rescue techniques.

• [Neurological complications of the regional anesthesia: Analysis of the expertises and conclusions of the Regional Commissions for Conciliation and Compensation.]

  Authors: M Aïssou, D Lemesle, S Abbas, A Lienhart

  Annales francaises d'anesthesie et de reanimation.

  All the files of complications of regional anaesthesias requiring an expertise for a Regional Commission for Conciliation and Compensation for medical accidents (CRCI) between 2003 and 2008 wereAll the files of complications of regional anaesthesias requiring an expertise for a Regional Commission for Conciliation and Compensation for medical accidents (CRCI) between 2003 and 2008 were analyzed. The objective was to estimate the homogeneity of the appointed experts, their opinions and the opinions of the CRCI. Querying the database, shared by the National Office for Compensation for Medical Accidents (ONIAM) and the CRCI, and identified 40 files corresponding to the selection criteria. The expertise carried out involved an anaesthetist in 27 cases, always registered, either on the national list of the experts in medical accidents, or on one list of court-appointed experts. Conversely, in 13 cases, no specialist performing himself the technique in question was involved in the expertise, and sometimes the expert was registered on any list. Mostly, the non-specialists do not conclude to medical malpractice. This was not the case in a single file, where the anaesthetist sought and obtained the addition of an anaesthetist in a new expertise, which concluded differently. Damages assessed were highly variable, but the given evidence provided to understand why. The CRCI have generally followed the opinions of the experts, except in a few cases where the evidence allowed a different opinion without requiring a new expertise. In conclusion, the abnormalities in the appointment of experts do not seem to have had consequences in terms of damage assessment, but may alter the balance between causes faulty and not faulty, in favour of the latter.

• [Comments on the principle of organ procurement following the withdrawal of life supporting therapies.]

  Authors: L Beydon

  Annales francaises d'anesthesie et de reanimation.

• [The perioperative period in cancer surgery: A critical moment! Is there a role for regional anesthesia in preventing cancer recurrence?]

  Authors: H Beloeil, K Nouette-Gaulain

  Annales francaises d'anesthesie et de reanimation.

  Surgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contributeSurgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contribute to the dissemination of the tumor: surgery itself, stress, inflammation, pain, anaesthetic drugs, blood transfusion, etc. The type of anaesthesia chosen in the cancer patient could then be crucial and influence the evolution of the disease. Experimental, preclinical and retrospective studies have suggested that a regional anesthesia associated or not with a general anesthesia for carcinologic surgery might reduce the risk of cancer recurrence. This text reviews the factors promoting the recurrence of tumors after carcinologic surgery and the potential possibilities of protection associated with the type of anaesthesia chosen.

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