Musa Sesay

• Doctor of Medicine
• Researcher at Centre Hospitalier Universitaire de Bordeaux

Purpose The optic nerve (ON) is an extension of the central nervous system via the optic canal to the orbital cavity. It is accompanied by meninges whose arachnoid layer is in continuity with that of the chiasmatic cistern. This arachnoid layer is extended along the ON, delimiting a subarachnoid space (SAS) around the ON. Not all forms of chronic i...

Study objective Our objective was to develop a clinical scale (the VENSCORE) to predict pre-operative peripheral intravenous cannula (PIVC) insertion failure at the first attempt in adults. Design This was a prospective multicenter cohort study that included internal validation with bootstrapping. Setting The operating rooms of 14 hospitals in so...

Introduction The use of direct oral anticoagulants (DOAC) is increasing. Specific concentrations are available and have been proven to be reliable and reproducible in optimising patient care. This retrospective, monocentric study aimed to describe the indications and consequences of monitoring DOAC plasma levels on patient care. Materials and meth...

The aim of this work was to determine reliable anatomical landmarks for locating and preserving the abducens nerves (6th cranial nerves) during trans-facial or trans-nasal endoscopic approaches of skull base tumors involving the clivus and the petrous apex. In order to describe this specific anatomy, we carefully dissected 10 cadaveric heads under...

Background and Aims: Surgery for pheochromocytoma (PCC) can cause excessive catecholamine release with severe hypertension. Alpha blockade is the mainstay of preoperative management. The aim of this study was to evaluate the efficacy and tolerance of intra-venous (IV) urapidil, a competitive short acting α1 receptor antagonist, in the prevention of...

Background: Dynamic arterial elastance (Eadyn), defined as the ratio between pulse pressure variations and stroke volume variations, has been proposed to assess functional arterial load. We evaluated the evolution of Eadyn during volume expansion and the effects of neosynephrine infusion in hypotensive and preload-responsive patients. Methods: I...

Background: Many maneuvers assessing fluid responsiveness (minifluid challenge, lung recruitment maneuver, end-expiratory occlusion test, passive leg raising) are considered as positive when small variations in cardiac index, stroke volume index, stroke volume variation or pulse pressure variation occur. Pulse contour analysis allows continuous an...

Background: In mechanically ventilated patients, an increase in cardiac index during an end-expiratory-occlusion test predicts fluid responsiveness. To identify this rapid increase in cardiac index, continuous and instantaneous cardiac index monitoring is necessary, decreasing its feasibility at the bedside. Our study was designed to investigate w...

Background: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume e...

Introduction: Dynamic arterial elastance (Eadyn) is defined as the ratio between pulse pressure variations (PPV) and stroke volume variations (SVV). Eadyn has been proposed to predict an increase in mean arterial pressure (MAP) after volume expansion with conflicting results. The aim of the present study was to test the reliability of Eadyn in hyp...

Background: Mini-fluid challenge of 100 ml colloids is thought to predict the effects of larger amounts of fluid (500 ml) in intensive care units. This study sought to determine whether a low quantity of crystalloid (50 and 100 ml) could predict the effects of 250 ml crystalloid in mechanically ventilated patients in the operating room. Methods:...

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Proceedings of Réanimation 2017, the French Intensive Care Society International Congress Paris, France. 11–13 January 2017 https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-016-0223-8

Background: The accuracy of currently available devices using pulse contour analysis without external calibration for cardiac index (CI) estimation is negatively impacted by hyperdynamic states, low systemic vascular resistance (SVR), and abrupt changes in SVR. The aim of this study was to evaluate the accuracy of a new device, the Pulsioflex (Pul...

Background: Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. Methods: Twenty-eight mechanically ventilated patients with low tidal volume du...

Introduction Les patients adultes obèses subissent un taux d’échec supérieur aux patients ayant un indice de masse corporelle (IMC) normal pour la pose de la voie veineuse périphérique (VVP) [1]. En effet, l’obésité est un facteur prédictif de difficulté d’accès veineux périphérique [2]. Quels moyens avons-nous pour améliorer la réussite ? La trans...

Object: Sacral roots are involved in sensory, autonomic, and motor innervation of the lower limbs and perineum. Theoretically, it can be assumed that the S-3 root level innervates the bladder; however, clinical practice shows that this distribution can vary. Few researchers have studied this variability. Methods: The authors conducted a retrospe...

Background: The autonomic nervous system is influenced by many stimuli including pain. Heart rate variability (HRV) is an indirect marker of the autonomic nervous system. Because of paucity of data, this study sought to determine the optimal thresholds of HRV above which the patients are in pain after minor spinal surgery (MSS). Secondly, we evalu...

Background and Aims: Intravenous (I.V.) lidocaine has analgesic, antihyperalgesic and anti-inflammatory properties and is known to accelerate the return of bowel function after surgery. We evaluated the effects of I.V. lidocaine on pain management and acute rehabilitation protocol after laparoscopic nephrectomy. Materials and Methods: A total of 4...

Background: Preventing postoperative nausea and vomiting (PONV) is a major priority for postsurgical patient care. Our objective was to assess the efficacy of a multimodal postoperative nausea and vomiting (PONV) approach, which was associated with a continuous quality improvement program, in maintaining a low PONV incidence in the PACU. Methods:...

Transcutaneous cranial electrical stimulation (TCES) delivers a high-frequency (166 kHz) pulsed biphasic balanced current with a pulse repetition frequency of 100 Hz with 40% duty cycle through a negative electrode and two positive electrodes over the skull. TCES has a proven ability to potentiate anesthesia and analgesia, although the physiologica...

The use of an awake craniotomy in the treatment of supratentorial lesions is a challenge for both patients and staff in the operation theater. To assess the safety and effectiveness of an awake craniotomy with brain mapping in comparison with a craniotomy performed under general anesthesia. We prospectively compared 2 groups of patients who underwe...

A third case of corpus callosum hemangioblastoma (HB) is presented. With no preoperative embolization, surgery was uneventful and the postoperative course was excellent. Based on the literature, we attempted to clarify the histogenesis of HB and to explain why they are exceptional in the supratentorial region in contrast to the posterior cranial fo...

To assess the practical feasibility and effectiveness of real-time magnetic resonance (MR) temperature monitoring for the radiofrequency (RF) ablation of liver tumours in a clinical setting, nine patients (aged 49-87 years, five men and four women) with one malignant tumour (14-50 mm, eight hepatocellular carcinomas and one colorectal metastasis),...

Uncontrolled head motion during CT/MRI cerebral blood flow (CBF) imaging has been estimated between 3 and 15% of the cases. We present a pharmacological approach which permitted us to maintain the incident at 0.06% with few side effects. The protocol involves the systematic use of general anesthesia (sevoflurane) in children below five years and th...

Acute hearing loss is a rare complication of anaesthesia. It could be related to CSF hypopressure secondary to dura mater puncture or to the use of nitrous oxide responsible for endolymphatic hyperpressure. Hearing loss requires a complete checking. Bloody tap may be useful after dura mater breach.

In a multicenter study, 102 patients aged 70 years or older with paraplegia or severe paraparesis, and who underwent operation for spinal meningiomas, are presented to correlate surgery and outcome and to determine the most influential factors that affected this outcome. Five French neurosurgical centers participated in this retrospective study bet...

Unlabelled: Percutaneous vertebroplasty (PVP) consists of injecting small quantities of orthopedic cement to consolidate pathologic vertebral bodies. The procedure is brief but painful during vertebral puncture and cement injection requiring either general anesthesia or monitored anesthesia care with opioids. The optimal dose of alfentanil in this...

The preparation for phaeochromocytoma surgery is a matter of debate. Pre-operative blockade of alpha-1 receptors is increasingly employed in an attempt to reduce the risk of hypertensive episodes, especially during manipulation of the tumour. In this study, we compared the interest of an almost complete blockade of these receptors by high doses of...

This prospective, randomized, double-dummy study was undertaken to compare the effects of magnesium sulphate (MgSO(4)) administered by the intravenous vs. the infiltration route on postoperative pain and analgesic requirements. Forty ASA I or II men scheduled for radical retropubic prostatectomy under general anaesthesia were randomized into two gr...

The effects of MRI acoustic noise on anaesthesia safety concerns have not yet been documented. The objectives of this study were to provide subjective and objective evaluations of anaesthesia alarm audibility during MRI and to review the literature to determine whether or not to worry about our results. Following Institutional Review Board's approv...

Peritumoral brain edema (PTBE) is often associated with meningiomas. PTBE is probably implicated in the complications occurring in intracranial meningiomas. The goal of this study was to determine the exact implication of PTBE in prognosis. Thirty consecutive patients who underwent surgery for intracranial meningiomas were investigated over a 1-yea...

We studied sympathovagal activity using real-time heart rate variability (HRV) and determined its relationship with plasma catecholamines to characterize short-term cardioregulatory mechanisms during laparoscopic adrenal pheochromocytoma surgery. We recruited 20 patients with pheochromocytoma (Group P) and 20 with incidentaloma (Group I). HRV, syst...

The aims of this study are to assess the surgical outcome of elderly patients aged 80 years or more, to analyze the factors influencing postoperative course, and to propose a grading system to standardize the surgical indication of intracranial meningioma in the elderly. Between 1990 and 2005, we surgically treated 74 consecutive patients aged 80 y...

Bladder discomfort related to an indwelling catheter can exacerbate postoperative pain. It mimics overactive bladder syndrome that is resistant to conventional opioid therapy. Muscarinic receptor antagonists are effective for treatment of the overactive bladder. The aim of this study was to assess the efficacy of oxybutynin in the management of pos...

The purpose of this study was to assess whether the addition of intravenous magnesium sulphate (Mg) at the induction of anaesthesia to a balanced anaesthetic protocol including wound infiltration, paracetamol and tramadol resulted in improved analgesic efficiency after radical prostatectomy. We conducted a randomized, double-blind, controlled study...

This report describes the perioperative management of disseminated intravascular coagulation occurring abruptly during a planned cystectomy for non-metastatic bladder papillary carcinoma. Peroperatively, profuse bleeding and an acute decrease in blood pressure were effectively treated by blood transfusions and fresh frozen plasma. Haematological te...

Background and Purpose— Numerous imaging techniques have been developed and applied to evaluate brain hemodynamics. Among these are positron emission tomography, single photon emission computed tomography, Xenon-enhanced computed tomography, dynamic perfusion computed tomography, MRI dynamic susceptibility contrast, arterial spin labeling, and Dopp...

The target effect-site concentration of propofol to insert a laryngeal mask airway was recently reported as almost 5 microg mL(-1). The present study aimed to determine the target effect-site concentration with target-controlled infusion of propofol to place classical larnygeal mask airway or current laryngeal tube in adult patients. We included 40...

Numerous imaging techniques have been developed and applied to evaluate brain hemodynamics. Among these are positron emission tomography, single photon emission computed tomography, Xenon-enhanced computed tomography, dynamic perfusion computed tomography, MRI dynamic susceptibility contrast, arterial spin labeling, and Doppler ultrasound. These te...

Summary Numerous imaging techniques have been developed and applied to evaluate brain hemodynamics. Among these are: Positron Emission Tomography (PET), Single Photon Emission Computed Tomography (SPECT), Xenon-enhanced Computed Tomography (XeCT), Dynamic Perfusion-computed Tomography (PCT), Magnetic Resonance Imaging Dynamic Susceptibility Contra...

The lower urinary tract has two main functions: storage and periodic elimination of urine. These two functions are regulated by a complex neural control system involving a central pathway located in the spinal cord, pons and brain as well as by the peripheral autonomic and somatic neural pathways. Vesico-urethral dysfunction is a major problem in d...

Laparoscopic surgery for phaeochromocytoma can cause excessive catechol amine release with severe hypertension and sinus tachycardia. i.v. calcium antagonists may be used to prevent increases in blood pressure during phaeochromocytoma resection. We investigated the effects of perioperative alpha(1) adrenergic block with urapidil on intraoperative h...

Objectifs La tomodensitométrie avec inhalation du xénon (XeCT) est l’une des techniques de référence pour la mesure quantitative du débit sanguin cérébral (DSC) [Stroke 2003 ; 34 : 1084-1104]. L’objectif de cette étude est d’identifier les avantages et contraintes du XeCT pour l’homme. Matériels et Méthodes Après leur consentement éclairé, 50 pati...

Objectifs Évaluer l’influence de l’angioplastie carotidienne sur la perfusion cérébrale par une méthode quantitative à l’aide du scanner au Xenon. Matériels et méthodes 7 patients ont été suivi de manière prospective par un examen de la perfusion cérébrale avant une angioplastie carotidienne et un mois après. Tous les patients étaient porteurs d’u...

Patients with spinal cord lesions are exposed to vesico-sphincter dysfunctions which can aggravate the vital or functional prognosis. The pathophysiological characteristics of these neurogenic bladders explains the usefulness of surgical treatment. The objective of the Brindley technique is to improve both voiding and effective continence. Any pati...

To assess the efficacy of ECG spectral analysis, compared with heart rate (HR) monitoring in the detection of vagal response to surgical stimuli. Twenty Asa II-III patients (age: 65 +/- 13 years) scheduled for surgery of cerebellopontine angle or implantation of sacral root stimulator were examined. Target controlled infusion of propofol (2-4 micro...

Objective. – To assess the efficacy of ECG spectral analysis, compared with heart rate (HR) monitoring in the detection of vagal response to surgical stimuli.Methods. – Twenty Asa II–III patients (age: 65 ± 13 years) scheduled for surgery of cerebellopontine angle or implantation of sacral root stimulator were examined. Target controlled infusion o...

There are five types of oedema: vasogenic, cytotoxic, interstitial, hyperemic and osmotic. The differences lie on the type and localization of the oedema, the state of the blood-brain barrier (BBB) and the pathological context. Under physiological conditions, the osmolarity of extra cellular fluids (ECFs) is equal on both sides of the BBB. However,...

There are five types of cerebral oedema: vasogenic, cytotoxic, interstitial, hyperemic and osmotic. The differences lie on the type and localization of the oedema, the state of the blood-brain barrier (BBB) and the pathological context. Under physiological conditions, the osmolarity of extra cellular fluids (ECFs) is equal on both sides of the BBB....

To compare spectral analysis of the electrocardiogram (ECG) with mean arterial pressure (MAP) and heart rate (HR) monitoring in the detection of autonomic hyperreflexia (AHR) induced by sacral root stimulation. Ten spinal cord injured patients scheduled for implantation of a sacral root stimulator for bladder retention were included. Under target c...

The aim of this study was to compare the analgesic efficacy of three different postoperative treatments after supratentorial craniotomy. Sixty-four patients were allocated prospectively and randomly into three groups: paracetamol (the P group, n = 8), paracetamol and tramadol (the PT group, n = 29), and paracetamol and nalbuphine (the PN group, n =...

The symptomatic treatment of hydrocephalus remains cerebrospinal fluid (CSF) drainage to an external reservoir (external CSF drainage) or to an internal cavity mainly the peritoneum or the right atrium via a unidirectional valve (internal CSF drainage) and finally by endoscopic ventriculocisternostomy. Local anaesthesia is adequate for external CSF...

To assess the safety and efficacy of intraosseous lidocaine (IL), in comparison with iv nalbuphine and propacetamol (NP) for analgesia during percutaneous vertebroplasty (PV) in order to avoid general anesthesia in elderly patients. Patients (age 68 +/- 13 yr, weight 66 +/- 6 kg) undergoing PV for osteoporotic fractures were randomized prospectivel...

The symptomatic treatment of hydrocephalus remains cerebrospinal fluid (CSF) drainage to an external reservoir (external CSF drainage) or to an internal cavity mainly the peritoneum or the right atrium via a unidirectional valve (internal CSF drainage) and finally by endoscopic ventriculocisternostomy. Local anaesthesia is adequate for external CSF...

The symptomatic treatment of hydrocephalus remains cerebrospinal fluid (CSF) drainage to an external reservoir (external CSF drainage) or to an internal cavity mainly the peritoneum or the right atrium via a unidirectional valve (internal CSF drainage) and finally by endoscopic ventriculocisternostomy. Local anaesthesia is adequate for external CSF...

Purpose: To report a case of multi-organ embolism by cholesterol crystals. Clinical features; A 68 year-old man with chronic vasculopathy (hypertension, lower limb arteritis and renal insufficiency) suffered from thoracic pain during haemodialysis. A coronarography revealed the existance of an ulcerated plaque of atheroma floating at the level of d...

A spinal cord lesion above the sacral micturition center results in a loss of voluntary control and development of bladder sphincter dysynergia with hyperreflexia of the detrusor and spasticity of the sphincter. Sacral rhizotomy and implantation of an anterior sacral root stimulator appears as an effective method for the treatment not only of voidi...

Because of its anesthetic properties, inhalation of 30-35% Xenon is associated with uncontrolled patient motion in 3-15% of the cases. This constitutes a major setback to regional cerebral blood flow studies with Xenon-enhanced computed tomography (Xe-CT CBF). The present study attempted to determine the effects of oral premedication with hydroxyzi...

It is suggested that mastication stimulates the brain and accelerates its energy-consuming metabolism. This study was designed to determine its effects on regional cerebral blood flow (rCBF) using xenon-enhanced computed tomography (Xe-CT). Seven male volunteers, aged 24-57 years, inhaled 30% xenon in a 4 minutes wash-in and 4 minutes wash-out prot...

A retrospective study of 716 patients aged 60 years and above (324 men, 392 women) was undertaken in order to determine quality control in burns management in the South West of France. The following epidemiological data was obtained: high hospitalization rate (7 per cent of the general admissions); monthly and seasonal periodicity; predominance of...