Praticien en Anesthesie Reanimation最新文献

{"title":"Retour d’expérience sur la mise en place de la péridurale déambulatoire dans une maternité de niveau 3","authors":"Audrey Breckler ,&nbsp;Hélène Solus","doi":"10.1016/j.pratan.2025.02.001","DOIUrl":"10.1016/j.pratan.2025.02.001","url":null,"abstract":"<div><div>Cet article explique la mise en place de l’analgésie péridurale ambulatoire dans une maternité de niveau 3. Elle passe par une phase d’explication auprès des soignants et de sélection des parturientes qui en bénéficieront a priori et qui recevront des explications détaillées sur la procédure. Le protocole d’analgésie est modifié pour tenir compte de l’ambulation et minimiser les effets secondaires. Le premier lever doit être encadré pour éviter les conséquences d’un bloc moteur ou d’une hypotension orthostatique. L’expérience acquise avec 100 parturientes montre qu’elles choisissent l’ambulation si elles en ont les critères et qu’elles apprécient la possibilité d’avoir recours à ce choix mais qu’elles ne l’exploitent pas durant toute la durée du travail même si elles en sont satisfaites.</div></div><div><div>This article explains the implementation of ambulatory epidural analgesia in a level 3 maternity ward. It goes through a phase of explanation to caregivers and selection of parturients who will benefit from it a priori and who will receive detailed explanations on the procedure. The epidural analgesia protocol is modified to take into account ambulation and minimize side effects. The first rise must be supervised to avoid the consequences of a motor block or orthostatic hypotension. Experience concerning one hundred parturients shows that they choose ambulation if they have the criteria and that they appreciate the possibility of having recourse to this choice but that they do not exploit it throughout the duration of labor even if they are satisfied with it.</div></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 2","pages":"Pages 105-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lésion traumatique ecchymotique de la base de l’épiglotte","authors":"Hélène Solus","doi":"10.1016/j.pratan.2025.02.002","DOIUrl":"10.1016/j.pratan.2025.02.002","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 2","pages":"Page 128"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les patients regrettent-ils une décision d’intervention ?","authors":"Francis Bonnet","doi":"10.1016/j.pratan.2025.02.003","DOIUrl":"10.1016/j.pratan.2025.02.003","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 2","pages":"Pages 69-70"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les nouvelles pratiques de thromboprophylaxie dans le cadre de la récupération améliorée après chirurgie (RAC) après prothèse de hanche et de genou","authors":"Jean-Yves Jenny","doi":"10.1016/j.pratan.2025.02.007","DOIUrl":"10.1016/j.pratan.2025.02.007","url":null,"abstract":"<div><div>La chirurgie prothétique de la hanche et du genou peut être compliquée de thrombose veineuse et d’embolie pulmonaire. Le risque d’embolie est associé aux thromboses proximales. L’incidence des décès par embolie pulmonaire est de l’ordre de 1 %. La prévention reposait principalement sur les héparines de bas poids moléculaire. De plus en plus de données soutiennent une efficacité non inférieure de l’aspirine qui induit un risque hémorragique moindre.</div></div><div><div>Hip and knee prosthetic surgery can be complicated by venous thrombosis and pulmonary embolism. The risk of embolism is associated with proximal thromboses. The incidence of death from pulmonary embolism is around 1%. Prevention was mainly based on low molecular weight heparins. More and more data support a non-inferior effectiveness of aspirin, which induces a lower risk of bleeding.</div></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 2","pages":"Pages 84-89"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuffier, Fourneau, Chaput : trois hommes qui ont sauvé la rachianesthésie","authors":"Louis-Jean Dupré","doi":"10.1016/j.pratan.2024.11.001","DOIUrl":"10.1016/j.pratan.2024.11.001","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Pages 56-61"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lu pour vous","authors":"","doi":"10.1016/j.pratan.2024.12.001","DOIUrl":"10.1016/j.pratan.2024.12.001","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Pages 62-65"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validité des mesures de l’intensité douloureuse et comparaison des échelles entre elles","authors":"Claire Debes","doi":"10.1016/j.pratan.2024.12.006","DOIUrl":"10.1016/j.pratan.2024.12.006","url":null,"abstract":"<div><div>L’autoévaluation de la douleur est indispensable pour une prise en charge antalgique efficace et adaptée. Les 3 principales échelles d’autoévaluation chez l’adulte sont l’échelle visuelle analogique (EVA), l’échelle numérique (EN) et l’échelle verbale simple (EVS). Toutes sont valides et fiables, c’est-à-dire qu’elles sont capables de diagnostiquer de façon sûre et reproductible une douleur aiguë ou chronique. Parmi elles l’EN doit être privilégiée en pratique clinique en raison d’une plus grande simplicité d’utilisation que l’EVA, plus complexe à mettre en place car nécessitant un support physique. Celle-ci est à privilégier dans le cadre de la recherche clinique en raison de son fort pouvoir discriminant qui n’aura pas de réel intérêt en pratique. L’EVS quant à elle paraît moins fiable, en particulier dans le cadre de la douleur chronique, et son usage doit être réservé à des situations cliniques particulières.</div></div><div><div>Self-assessment of pain is critical for effective and appropriate analgesic management. In adults the 3 main self-report scales are the Visual Analogue Scale (VAS), the Numerical Rating Scale (NRS) and the Verbal Rating Scale (VRS). All of them are valid and reliable, meaning they are able to reliably and reproducibly diagnose acute and chronic pain. Among them, the NRS should be preferred in practice due to its greater simplicity of use compared to the VAS that is more complex to implement because it requires physical support. The VAS is preferred in the context of clinical research because of its strong discriminatory power, which will not be of real interest in practice. The VRS appears to be less reliable, particularly in the context of chronic pain, and its use should be reserved for specific clinical situations.</div></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Pages 17-21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agenda","authors":"","doi":"10.1016/S1279-7960(25)00020-8","DOIUrl":"10.1016/S1279-7960(25)00020-8","url":null,"abstract":"","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Page 68"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crise drépanocytaire en salle de travail obstétrical","authors":"Martine Ferrand","doi":"10.1016/j.pratan.2024.12.002","DOIUrl":"10.1016/j.pratan.2024.12.002","url":null,"abstract":"<div><div>Cette rubrique a pour objectif d’illustrer les principes et l’application de la démarche des revues morbi-mortalité. Elle propose un schéma d’analyse et de prévention de la récidive des évènements adverses. L’exemple choisi se situe dans le contexte obstétrical.</div></div><div><div>This section aims to illustrate principles and applications of morbidity and mortality reviews. It introduces a scheme for analysing and preventing recidivism of adverse events. The example chosen this time takes place in obstetrics.</div></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Pages 51-55"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilisation de l’acide tranexamique en péripartum","authors":"Marine Clavaud ,&nbsp;Marie-Pierre Bonnet","doi":"10.1016/j.pratan.2024.11.002","DOIUrl":"10.1016/j.pratan.2024.11.002","url":null,"abstract":"<div><div>L’acide tranexamique (AT) grâce à son action anti-fibrinolytique, réduit le saignement. Depuis l’étude WOMAN publiée en 2016, l’AT est recommandé dans les algorithmes de prise en charge de l’HPP. Son administration réduit de 30 % la mortalité maternelle par saignement. Elle doit être effectuée le plus tôt possible, à la dose de 1<!--> <!-->g, renouvelable une fois dans les 30<!--> <!-->min si persistance du saignement ou dans les 24<!--> <!-->h si récidive. La dose maximale est de 2<!--> <!-->g par jour. Au-delà, les patientes ont un risque de nécrose corticale rénale et d’épilepsie. En prévention de l’HPP, les principaux essais, contrôlés, randomisés, double aveugle de forte puissance (TRAAP, TRAAP2, PACHECO) montrent que l’injection d’AT avant une césarienne ou un accouchement par voie basse, chez des patientes non à risque hémorragique, ne permet pas de diminuer le risque d’HPP<!--> <!-->≥<!--> <!-->500<!--> <!-->mL, le risque de transfusion et l’incidence de la mortalité. L’utilisation d’AT n’est donc pas recommandée de manière systématique dans la prévention de l’HPP mais quelques sociétés savantes comme la NATA et l’EJA commencent à préconiser son utilisation chez des patientes à risque hémorragique dans l’attente des résultats des essais multicentriques en cours chez les parturientes à risque (TRAAPPraevia et WOMAN2).</div></div><div><div>Due to its antifibrinolytic effect, tranexamic acid (TA) reduces the volume of haemorrhage. Since the WOMAN study, published in 2016, TA is recommended for the treatment of postpartum haemorrhage (PPH). TA results in a 30% decrease in PPH-related mortality. The 1<!--> <!-->g dose has to be administered as soon as possible and repeated only once at 30<!--> <!-->min. in case of persisting haemorrhage up to a maximum of 2<!--> <!-->g per day. Higher doses convey a risk of renal cortical necrosis and seizures. The main randomised controlled multicentre trials (TRAAP, TRAAP2, PACHECO) conclude that preventive administration before vaginal delivery or caesarean section does not reduce the incidence of PPH, blood transfusion and mortality in patients not at risk. The systematic use in this setting is not recommended but could be restricted to women at risk according to NATA and EJA recommendations until the results of current studies (TRAAPPRAEVIA, WOMAN2) will be available.</div></div>","PeriodicalId":52613,"journal":{"name":"Praticien en Anesthesie Reanimation","volume":"29 1","pages":"Pages 4-10"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}