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Publisher: Elsevier   (Total: 3160 journals)

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Showing 1 - 200 of 3160 Journals sorted alphabetically
Academic Pediatrics     Hybrid Journal   (Followers: 35, SJR: 1.655, CiteScore: 2)
Academic Radiology     Hybrid Journal   (Followers: 24, SJR: 1.015, CiteScore: 2)
Accident Analysis & Prevention     Partially Free   (Followers: 96, SJR: 1.462, CiteScore: 3)
Accounting Forum     Hybrid Journal   (Followers: 27, SJR: 0.932, CiteScore: 2)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 37, SJR: 1.771, CiteScore: 3)
Achievements in the Life Sciences     Open Access   (Followers: 5)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 7)
Acta Astronautica     Hybrid Journal   (Followers: 420, SJR: 0.758, CiteScore: 2)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 2)
Acta Biomaterialia     Hybrid Journal   (Followers: 28, SJR: 1.967, CiteScore: 7)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 2)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Ecologica Sinica     Open Access   (Followers: 10, SJR: 0.18, CiteScore: 1)
Acta Haematologica Polonica     Free   (Followers: 1, SJR: 0.128, CiteScore: 0)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.661, CiteScore: 2)
Acta Materialia     Hybrid Journal   (Followers: 277, SJR: 3.263, CiteScore: 6)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.504, CiteScore: 1)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.542, CiteScore: 1)
Acta Oecologica     Hybrid Journal   (Followers: 12, SJR: 0.834, CiteScore: 2)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription  
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.307, CiteScore: 0)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1, SJR: 1.793, CiteScore: 6)
Acta Poética     Open Access   (Followers: 4, SJR: 0.101, CiteScore: 0)
Acta Psychologica     Hybrid Journal   (Followers: 27, SJR: 1.331, CiteScore: 2)
Acta Sociológica     Open Access   (Followers: 1)
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.052, CiteScore: 2)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3, SJR: 0.374, CiteScore: 1)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.344, CiteScore: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 6, SJR: 0.19, CiteScore: 0)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 8)
Acute Pain     Full-text available via subscription   (Followers: 14, SJR: 2.671, CiteScore: 5)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.53, CiteScore: 4)
Addictive Behaviors     Hybrid Journal   (Followers: 17, SJR: 1.29, CiteScore: 3)
Addictive Behaviors Reports     Open Access   (Followers: 8, SJR: 0.755, CiteScore: 2)
Additive Manufacturing     Hybrid Journal   (Followers: 11, SJR: 2.611, CiteScore: 8)
Additives for Polymers     Full-text available via subscription   (Followers: 23)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 167, SJR: 4.09, CiteScore: 13)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 12, SJR: 1.167, CiteScore: 4)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.694, CiteScore: 3)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.277, CiteScore: 1)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.384, CiteScore: 5)
Advances in Anesthesia     Full-text available via subscription   (Followers: 28, SJR: 0.126, CiteScore: 0)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 10, SJR: 0.992, CiteScore: 1)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 1.551, CiteScore: 4)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 24, SJR: 2.089, CiteScore: 5)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 14, SJR: 0.572, CiteScore: 2)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.61, CiteScore: 7)
Advances in Botanical Research     Full-text available via subscription   (Followers: 2, SJR: 0.686, CiteScore: 2)
Advances in Cancer Research     Full-text available via subscription   (Followers: 33, SJR: 3.043, CiteScore: 6)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 1.453, CiteScore: 2)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 1.992, CiteScore: 5)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 13)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 28, SJR: 0.156, CiteScore: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.713, CiteScore: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.316, CiteScore: 2)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26, SJR: 1.562, CiteScore: 3)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 20, SJR: 1.977, CiteScore: 8)
Advances in Computers     Full-text available via subscription   (Followers: 14, SJR: 0.205, CiteScore: 1)
Advances in Dermatology     Full-text available via subscription   (Followers: 15)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 12)
Advances in Digestive Medicine     Open Access   (Followers: 9)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 7)
Advances in Drug Research     Full-text available via subscription   (Followers: 25)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44, SJR: 2.524, CiteScore: 4)
Advances in Engineering Software     Hybrid Journal   (Followers: 29, SJR: 1.159, CiteScore: 4)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 8)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 46, SJR: 5.39, CiteScore: 8)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 1)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 9)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 60, SJR: 0.591, CiteScore: 2)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 17)
Advances in Genetics     Full-text available via subscription   (Followers: 19, SJR: 1.354, CiteScore: 4)
Advances in Genome Biology     Full-text available via subscription   (Followers: 10, SJR: 12.74, CiteScore: 13)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 1.193, CiteScore: 3)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 24, SJR: 0.368, CiteScore: 1)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 12, SJR: 0.749, CiteScore: 3)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 23)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.193, CiteScore: 0)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.433, CiteScore: 6)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 10, SJR: 1.163, CiteScore: 2)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 2, SJR: 1.938, CiteScore: 3)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6, SJR: 0.176, CiteScore: 0)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.682, CiteScore: 2)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 18, SJR: 0.88, CiteScore: 2)
Advances in Mathematics     Full-text available via subscription   (Followers: 11, SJR: 3.027, CiteScore: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 7, SJR: 0.694, CiteScore: 2)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.158, CiteScore: 3)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 23)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 8)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.182, CiteScore: 0)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 2)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 17, SJR: 1.875, CiteScore: 4)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.174, CiteScore: 0)
Advances in Parasitology     Full-text available via subscription   (Followers: 5, SJR: 1.579, CiteScore: 4)
Advances in Pediatrics     Full-text available via subscription   (Followers: 25, SJR: 0.461, CiteScore: 1)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 12)
Advances in Pharmacology     Full-text available via subscription   (Followers: 16, SJR: 1.536, CiteScore: 3)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.574, CiteScore: 1)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.109, CiteScore: 1)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 10)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 5)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 19)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 0.791, CiteScore: 2)
Advances in Psychology     Full-text available via subscription   (Followers: 65)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 6, SJR: 0.371, CiteScore: 1)
Advances in Radiation Oncology     Open Access   (Followers: 1, SJR: 0.263, CiteScore: 1)
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.101, CiteScore: 0)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 6)
Advances in Space Research     Full-text available via subscription   (Followers: 405, SJR: 0.569, CiteScore: 2)
Advances in Structural Biology     Full-text available via subscription   (Followers: 5)
Advances in Surgery     Full-text available via subscription   (Followers: 12, SJR: 0.555, CiteScore: 2)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 34, SJR: 2.208, CiteScore: 4)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 18)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 14)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 2.262, CiteScore: 5)
Advances in Water Resources     Hybrid Journal   (Followers: 48, SJR: 1.551, CiteScore: 3)
Aeolian Research     Hybrid Journal   (Followers: 6, SJR: 1.117, CiteScore: 3)
Aerospace Science and Technology     Hybrid Journal   (Followers: 357, SJR: 0.796, CiteScore: 3)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.42, CiteScore: 2)
African J. of Emergency Medicine     Open Access   (Followers: 6, SJR: 0.296, CiteScore: 0)
Ageing Research Reviews     Hybrid Journal   (Followers: 11, SJR: 3.671, CiteScore: 9)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 463, SJR: 1.238, CiteScore: 3)
Agri Gene     Hybrid Journal   (Followers: 1, SJR: 0.13, CiteScore: 0)
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 17, SJR: 1.818, CiteScore: 5)
Agricultural Systems     Hybrid Journal   (Followers: 31, SJR: 1.156, CiteScore: 4)
Agricultural Water Management     Hybrid Journal   (Followers: 42, SJR: 1.272, CiteScore: 3)
Agriculture and Agricultural Science Procedia     Open Access   (Followers: 4)
Agriculture and Natural Resources     Open Access   (Followers: 3)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 57, SJR: 1.747, CiteScore: 4)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.589, CiteScore: 3)
Air Medical J.     Hybrid Journal   (Followers: 6, SJR: 0.26, CiteScore: 0)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.19, CiteScore: 0)
Alcohol     Hybrid Journal   (Followers: 12, SJR: 1.153, CiteScore: 3)
Alcoholism and Drug Addiction     Open Access   (Followers: 11)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.604, CiteScore: 3)
Alexandria J. of Medicine     Open Access   (Followers: 1, SJR: 0.191, CiteScore: 1)
Algal Research     Partially Free   (Followers: 10, SJR: 1.142, CiteScore: 4)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 2)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.504, CiteScore: 1)
Allergology Intl.     Open Access   (Followers: 5, SJR: 1.148, CiteScore: 2)
Alpha Omegan     Full-text available via subscription   (SJR: 3.521, CiteScore: 6)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 10, SJR: 0.201, CiteScore: 1)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 52, SJR: 4.66, CiteScore: 10)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4, SJR: 1.796, CiteScore: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4, SJR: 1.108, CiteScore: 3)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 6)
American Heart J.     Hybrid Journal   (Followers: 56, SJR: 3.267, CiteScore: 4)
American J. of Cardiology     Hybrid Journal   (Followers: 59, SJR: 1.93, CiteScore: 3)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 44, SJR: 0.604, CiteScore: 1)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 11)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 13, SJR: 1.524, CiteScore: 3)
American J. of Human Genetics     Hybrid Journal   (Followers: 34, SJR: 7.45, CiteScore: 8)
American J. of Infection Control     Hybrid Journal   (Followers: 28, SJR: 1.062, CiteScore: 2)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 35, SJR: 2.973, CiteScore: 4)
American J. of Medicine     Hybrid Journal   (Followers: 48)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3, SJR: 1.967, CiteScore: 2)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 225, SJR: 2.7, CiteScore: 4)
American J. of Ophthalmology     Hybrid Journal   (Followers: 66, SJR: 3.184, CiteScore: 4)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5, SJR: 0.265, CiteScore: 0)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.289, CiteScore: 1)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, CiteScore: 1)
American J. of Pathology     Hybrid Journal   (Followers: 28, SJR: 2.139, CiteScore: 4)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 29, SJR: 2.164, CiteScore: 4)
American J. of Surgery     Hybrid Journal   (Followers: 38, SJR: 1.141, CiteScore: 2)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.767, CiteScore: 1)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 7)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.144, CiteScore: 3)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 63, SJR: 0.138, CiteScore: 0)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 19, SJR: 0.411, CiteScore: 1)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anales de Pediatría     Full-text available via subscription   (Followers: 3, SJR: 0.277, CiteScore: 0)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription  
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5, SJR: 4.849, CiteScore: 10)
Analytica Chimica Acta     Hybrid Journal   (Followers: 43, SJR: 1.512, CiteScore: 5)
Analytical Biochemistry     Hybrid Journal   (Followers: 190, SJR: 0.633, CiteScore: 2)
Analytical Chemistry Research     Open Access   (Followers: 12, SJR: 0.411, CiteScore: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 13)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.683, CiteScore: 2)
Angiología     Full-text available via subscription   (SJR: 0.121, CiteScore: 0)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1, SJR: 0.111, CiteScore: 0)
Animal Behaviour     Hybrid Journal   (Followers: 204, SJR: 1.58, CiteScore: 3)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.937, CiteScore: 2)
Animal Reproduction Science     Hybrid Journal   (Followers: 7, SJR: 0.704, CiteScore: 2)

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Similar Journals
Journal Cover
Anaesthesia Critical Care & Pain Medicine
Journal Prestige (SJR): 0.411
Citation Impact (citeScore): 1
Number of Followers: 19  
 
  Full-text available via subscription Subscription journal
ISSN (Online) 2352-5568
Published by Elsevier Homepage  [3160 journals]
  • Ultrasound-guided transversus abdominis plane (TAP) block in pedicled
           groin flap
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): C. Nguyen, Q. Mathais, M. Cardinale, C. Drouin, B. Prunet, E. Meaudre
       
  • Ultrasound-guided erector spinae plane block provides effective
           perioperative analgesia and anaesthesia for thoracic mass excision: A
           report of two cases
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Sevim Cesur, Ayşe Nur Ay, Ahmet Murat Yayık, M. Emin Naldan, Yavuz Gürkan
       
  • Adherence to the law in brain death diagnosis: A national survey
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Elodie Chambade, Maxime Nguyen, Alain Bernard, Abdelouaid Nadji, Bélaïd Bouhemad
       
  • Ambulatory paediatric surgery in French non-paediatric surgical ambulatory
           units: Results of a nationwide survey: The OPERA study
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): C. Ecoffey, F. Aubrun, J.-L. Bosson, P. Albaladejo
       
  • Learning medial canthus retrobulbar anaesthesia for eye surgery:
           Ophthalmic surgeons versus anaesthetists
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Gilles Guerrier, Pierre-Raphaël Rothschild, Mathieu Lehmann, Francine Behar-Cohen, Christophe Baillard
       
  • Predictors of a successful medial canthus block for eye surgery
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Gilles Guerrier, Sylvie Rondet, Dalila Hallal, Jacques Levy, Christophe Baillard
       
  • Opioid-free anaesthesia. Why and how' A contextual analysis
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Patrice Forget If the use of natural opiates, such as opium, is more than millennial, the history of synthetic opioids begins after 1950, with the development of the so-called ‘modern’ anaesthetic techniques. In 1962, in Belgium, the use of fentanyl, the first synthetic opioid for use in anaesthesia, is described. Subsequently, the use of opioids at high doses during surgery became common. However, over the last twenty years, many studies have questioned this practice, highlighting the many unknowns as the side effects of these molecules. The so-called opioid-free anaesthesia (OFA) techniques were developed in parallel with a better understanding of perioperative pain. In this work, the following questions are addressed: Why is the human body producing endogenous opioids' Is the concept of pain valid during general anaesthesia' What are the effects of intraoperative opioids on postoperative pain' Is anaesthesia without opioids actually possible' With these questions, the reader can question the use of intraoperative opioids within an historical and evolutionary perspective. In the same time, if OFA is feasible, the research agenda still includes a formal testing of its added value over classical opioid-sparing techniques.
       
  • Evolution and organisation of trauma systems
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Jean Stéphane David, Pierre Bouzat, Mathieu Raux Over the last 20 years, numerous studies have fairly consistently reported an improvement in the prognosis of patients with severe trauma after the establishment of a trauma network. These systems can be either exclusive, in which all patients are referred only to a small number of specifically designated centres that meet strict criteria, or inclusive, in which patients may be referred to any hospital of a particular area according to capacity, which is observed in France. Hospitals are classified (level 1 to level 3) according to their technical facilities and the number of patients admitted for severe trauma, knowing that studies have also shown an improvement of the outcome for the most severely injured patients (haemorrhagic shock, severe head trauma), in hospitals with the greatest technical facilities and the most important activity. The triage of the patients to a suitable centre must be done after careful prehospital evaluation, which is made on clinical criteria (mechanism, injury, medical history), measurement of vital signs, calculation of scores (RTS, MGAP) or based on classifications. According to this assessment, the patients will then be triaged to a centre that has the capacity for the optimal and definitive management of these injuries. The goal is then to avoid under triage which is synonymous of retransfer, loss of time, and probably also prognosis worsening, and to avoid over triage that may induce an inadequate use of resources, activity overload and cost increase. Thus, it seems essential to develop trauma networks to improve mortality and morbidity of patients that undergone a severe injury. These trauma networks will then have to be evaluated and a register set up.
       
  • Comparison of Proaqt/Pulsioflex® and oesophageal Doppler for
           intraoperative haemodynamic monitoring during intermediate-risk abdominal
           surgery
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria ObjectiveTo compare cardiac index (CI) between Proaqt/PulsioFlex® and oesophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI.MethodsIn a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120 min). The ability to track fluid responsiveness was evaluated by measuring stroke volume variation, pulse pressure variation (PPV) and CI before and after a 250 ml fluid challenge and assessed by a receiver operating characteristic curve analysis.ResultsThe percentages of error before calibration were 51, 58, 82, 81% for 30, 60, 90 and 120 min, they were 39, 57, 65, and 54% after calibration. Trending ability is assumed by a 93% concordance rate after applying a 15% exclusion zone. The trend interchangeability rate was 13.75%. The area under the curve for fluid responsiveness measured by PPV and SVV PulsioFlex were respectively 0.67 [0.57–0.77], P 
       
  • Effect of fluid challenge on renal resistive index after major orthopaedic
           surgery: A prospective observational study using Doppler ultrasonography
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Fabrice Ferré, Philippe Marty, Cédric Folcher, Matt Kurrek, Vincent Minville BackgroundA postoperative renal resistive index (RRI) > 0.70 has the best threshold to early predict acute kidney injury (AKI). The response of RRI to a postoperative fluid challenge (FC) is unknown. The aim of our study was to assess the impact of a FC on RRI in suspected hypovolaemia patients after orthopaedic surgery.DesignIn this single-centre observational study, we prospectively screened 156 patients in the recovery room after having undergone a hip or knee replacement.InterventionsForty-six patients with a RRI > 0.70 and requiring FC were included. RRI and cardiac output (CO) were measured before and immediately after a fluid challenge with 500 mL of isotonic saline. A decrease in RRI > 5% was considered significant (renal responders).ResultsOverall, FC resulted in a consistent decrease in RRI (from 0.74 [0.72–0.79] to 0.70 [0.68–0.73], P 
       
  • Serious adverse events and deaths linked to poor ventilator use: A report
           of four closed claims
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): A. Theissen, V. Piriou, F. Fuz, M. Autran, P. Albaladejo, P. Trouiller Through this series of four closed claims, we highlight examples of accidents stemming from poor ventilator use. We then review the main issues in this regard as reported in the literature and by learned societies. This case series has led us to emphasise the need for safety procedures involving systematic checks prior to use, declaration and analysis of the risk, as well as feedback and teaching regarding ventilation systems.
       
  • Health related quality of life and predictive factors six months after
           intensive care unit discharge
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Nathan Ferrand, Cédrick Zaouter, Brigitte Chastel, Karim Faye, Catherine Fleureau, Hadrien Roze, Antoine Dewitte, Alexandre Ouattara BackgroundAdvances in critical care medicine have improved patients’ survival rate. However, physical and cognitive sequels after Intensive Care Unit (ICU) discharge remain substantial. Our objectives were to evaluate the Health-related Quality of Life (HRQL) at 6-month after ICU discharge and identify the risk factors of this outcomes.MethodsWe performed a single-centre prospective observational study. The components of Short Form 36 (SF-36) were analysed for assessing HRQL on preadmission and at 3- and 6-month after ICU discharge.ResultsDuring the study period, 438 patients were eligible for recruitment and 220 of them were included in the trial. During the follow-up period, bodily pain and role limitations relating to emotion were both improved in comparison to the preadmission status while physical role component was lower at 3- and 6- month after ICU discharge. There was no other significant change in the SF-36 domains. Mental as well as physical aggregates remained also unchanged. Most of preadmission SF-36 scores were lower in patients who died within the first 6 months of follow-up compared to those who are still alive. Factors independently associated with the 6-month HRQL were age, preadmission HRQL score, SAPS II, prolonged mechanical ventilation (> 3 days) and the occurrence of acute respiratory distress syndrome.ConclusionIn our Cohort, ICU stay does not seem to alter globally neither the mental nor the physical component of the HRQL at 6-month after the discharge. However, some domains of the SF-36 are subject to significant changes.
       
  • Strategic proposal for a national trauma system in France
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Tobias Gauss, Paul Balandraud, Julien Frandon, Julio Abba, Francois Xavier Ageron, Pierre Albaladejo, Catherine Arvieux, Sandrine Barbois, Benjamin Bijok, Xavier Bobbia, Jonathan Charbit, Fabrice Cook, Jean-Stephane David, Guillaume De Saint Maurice, Jacques Duranteau, Delphine Garrigue, Emmanuel Gay, Thomas Geeraerts, Julien Ghelfi, Sophie Hamada In this road map for trauma in France, we focus on the main challenges for system implementation, surgical and radiology training and upon innovative training techniques. Regarding system organisation: procedures for triage, designation and certification of trauma centres are mandatory to implement trauma networks on a national scale. Data collection with registries must be created, with a core dataset defined and applied through all registries. Regarding surgical and radiology training, diagnostic-imaging processes should be standardised and the role of the interventional radiologist within the trauma team and the trauma network should be clearly defined. Education in surgery for trauma is crucial and recent changes in medical training in France will promote trauma surgery as a specific sub-specialty. Innovative training techniques should be implemented and be based on common objectives, scenarios and evaluation, so as to improve individual and team performances. The group formulated 14 proposals that should help to structure and improve major trauma management in France over the next 10 years.
       
  • Severe pelvic trauma: A complex and challenging situation
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Vardon Bounes, Véronique Ramonda, Thomas Geeraerts
       
  • Regional anaesthesia for eye surgery: Future development for education and
           quality
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Philippe Cuvillon, Ariane Lannelongue, Jacques Ripart
       
  • Snake envenomations in French Guiana: First clinical assessment of an
           antivenom imported from Mexico
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): A. Nadaud, F. Perotti, L. de Haro, D. Boels
       
  • Ventilatory setting in Adult Respiratory Distress Syndrome: Don’t listen
           the sound of Sirens! But keep some dreams in your mind…
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Paolo Pelosi, Jean-Michel Constantin
       
  • A rare case of super-refractory epileptic status in pregnant woman:
           Schizencephaly
    • Abstract: Publication date: April 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 2Author(s): Nabil Jbili, Khalil Mounir, Hicham Kechna, Lotfi Bibiche, Jaouad Laoutid, Abdelatif Diai, Imane Traibi, Moulay Ahmed Hachimi Schizencephaly is an anomaly of the subtotal brain development, which occurs as the presence of a cleft lined with grey matter extending from subarachnoid space to the ventricles. It may be manifested by psychomotor retardation, paresis or partial seizures and drug-resistant convulsions. The clinical expression of schizencephaly depends on the bilaterality of the slit, its size and its seat. The diagnostic strategy of schizencephaly in the ante- and postnatal period has been revolutionised by MRI imaging, the only technique able to provide an accurate and complete lesional assessment, particularly in type I. We report the case of a 34-year-old pregnant woman at the 25th weeks of amenorrhea, who presented a super-refractory epileptic-status due to a right schizencephaly. The diagnosis of eclampsia was excluded. This case report is very particular cause of the late appearance of epileptic seizures in this pregnant woman who has never done so.
       
  • Haemodynamic changes and incisional bleeding after scalp infiltration of
           dexmedetomidine with lidocaine in neurosurgical patients
    • Abstract: Publication date: Available online 27 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Hyunzu Kim, Seung-Ho Choi, Sang-Hee Ha, Won-Seok Chang, Gyoung-A Heo, Jimyeong Jeong, Kyeong Tae Min BackgroundThe purpose of this randomised controlled study is to compare the haemodynamic changes and the degree of incisional bleeding after scalp infiltration of lidocaine and dexmedetomidine versus lidocaine and epinephrine for patients with hemi-facial spasm undergoing microvascular decompression.MethodsFifty-two patients were injected with 5 mL of 1% lidocaine with either dexmedetomidine (2 μg/mL) or epinephrine (1:100,000 dilution) to reduce scalp bleeding. Mean blood pressure and heart rate were recorded every minute for 15 minutes after scalp infiltration. The primary outcome was the incidence of predefined hypotension, which was treated with administration of 4 mg ephedrine as often as needed. The number of administrations and total amount of ephedrine administered were also recorded as a measure of the severity of hypotension. The neurosurgeon scored incisional bleeding by numeric rating scale from 0 (worst) to 10 (best).ResultsThe incidence of hypotension (68% vs. 34.8%, P = 0.02) and the frequency (P = 0.02) and total dose (P = 0.03) of ephedrine administered were lower in the dexmedetomidine group than in the epinephrine group. In addition, there was no difference in mean blood pressure between the two groups but heart rates were lower in the dexmedetomidine group (P = 0.01). Incisional site bleeding was better with epinephrine (median [interquartile range] of the numeric rating Score: 6 [4] in the dexmedetomidine group and 8 [2] in the epinephrine group; P 
       
  • Role of a long-lasting uterotonic drug in the implementation of a fast
           track rehabilitation protocol after caesarian section
    • Abstract: Publication date: Available online 25 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Suela Demiri, Fleur Kefelian, Monique Berl, François Goffinet, Thibaut Rackelboom
       
  • Evolution of neurological recovery during the first year after
           subarachnoid haemorrhage in a French university centre
    • Abstract: Publication date: Available online 25 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Raphaël Cinotti, Jean-Baptiste Putegnat, Karim Lakhal, Hubert Desal, Amandine Chenet, Kévin Buffenoir, Denis Frasca, Bernard Allaouchiche, Karim Asehnoune, Bertrand Rozec IntroductionThe evolution of neurological recovery during the first year after aneurysmal Subarachnoid Haemorrhage (SAH) is poorly described.PatientsPatients with SAH in one university hospital from March the 1st 2010, to December 31st 2012, with a one-year follow-up.MethodEvaluation was performed via phone call at 3, 6 and 12 months. Primary endpoint was poor neurological recovery (modified Rankin Scale 3–4–5–6), one year after SAH. Secondary endpoints were the incidence of lack of self-perceived previous health status recovery and incidence of cognitive disorders, one year after SAH. Risk factors of poor neurological recovery were retrieved with multivariable logistic regression.ResultsTwo hundred and eleven patients were included and 208 had a complete follow-up. One hundred and twenty (57.7%) patients were female, 112 (53.8%) had a WFNS grade I–II–III. Seventy (33.6%) patients displayed one-year poor neurological outcome and risk factors of poor outcome were age, baseline Glasgow Coma Score ≤ 8, external ventricular drainage, intra-cranial hypertension and angiographic vasospasm. We observed an improvement in good outcome at 3 months [112 (53.8%) patients], 6 months [127 (61.1%) patients] and one-year [138 (66.3%) patients]. Fifty-nine (35.3%) patients recovered previous health status, 96 (57.5%) had persistent behaviour disorders, and 71 (42.5%) suffered from memory losses at one year.DiscussionNeurological recovery seems to improve over time. The same key complications should be targeted worldwide in SAH patients.ConclusionNeurological complications in the following of SAH should be actively treated in order to improve outcome. The early neuro-ICU phase remains a key determinant of long-term recovery.
       
  • Management of antiplatelet therapy for non elective invasive procedures of
           bleeding complications: proposals from the French working group on
           perioperative haemostasis (GIHP), in collaboration with the French Society
           of Anaesthesia and Intensive Care Medicine (SFAR)
    • Abstract: Publication date: Available online 23 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): A Godier, D Garrigue, D Lasne, P Fontana, F Bonhomme, JP Collet, E de Maistre, B Ickx, Y Gruel, M Mazighi, P Nguyen, A Vincentelli, P Albaladejo, T Lecompte The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals on the management of antiplatelet therapy for non-elective invasive procedures or bleeding complications. The proposals were discussed and validated by a vote; all proposals could be assigned with a high strength.Emergency management of oral antiplatelet agents (APA) requires knowledge on their pharmacokinetic/pharmacodynamics parameters, evaluation of the degree of the alteration of haemostatic competence and the associated bleeding risk. Platelet function testing may be considered. When APA-induced bleeding risk may worsen the prognosis, measures should be taken to neutralise antiplatelet therapy by considering not only the efficacy of available means (which can be limited for prasugrel and even more for ticagrelor) but also the risks that these means expose the patient to. The measures include platelet transfusion at the appropriate dose and haemostatic agents (tranexamic acid; rFVIIa for ticagrelor). When possible, postponing non-elective invasive procedures at least for a few hours until the elimination of the active compound (which could compromise the effect of transfused platelets) or if possible a few days (reduction of the effect of APA) should be considered.
       
  • Acute respiratory distress syndrome after chest trauma: Epidemiology,
           specific physiopathology and ventilation strategies
    • Abstract: Publication date: Available online 17 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Severin Ramin, Jonathan Charbit, Samir Jaber, Xavier Capdevila
       
  • Levosimendan in Patients with Low Cardiac Output Syndrome Undergoing
           Cardiac Surgery: a systematic review and meta-analysis
    • Abstract: Publication date: Available online 17 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Junchen Zhu, Yu Zhang, Lvlin Chen, Yan He, Xiaoming Qing Levosimendan is an inotropic agent that has been shown in small studies to treat low cardiac output syndrome in cardiac surgery. However, large randomised controlled trials (RCTs) have been recently published and presented neutral results. We sought to determine the effect of levosimendan on mortality in adults with low ejection fraction undergoing cardiac surgery. We searched different databases: Medline, Embase, Cochrane Central Register of Controlled Trials, and clinical trial registries. We included RCTs comparing events in the levosimendan versus placebo in adult patients with ejection fraction≤ 35% undergoing cardiac surgery. Outcomes were mortality at 30-day, mortality beyond 30-day, acute kidney injury and myocardial infarction. Five trials with total of 1519 patients were selected. Four trials were rated as low risk of bias. Our meta-analysis showed no significant difference between levosimendan versus placebo mortality at 30-day (odds radio [OR], 0.62; 95% confidence intervals [CI], 0.32 to 1.20; I2 = 33%; high quality evidence) and mortality beyond 30-day (OR, 0.71; 95% CI, 0.46 to 1.11; I2 = 0%). Similarly, there were no significant differences between the levosimendan versus placebo in the incidence of acute kidney injury (OR, 0.61, 95% CI, 0.33-1.13) and myocardial infarction (OR 0.41, 95% CI 0.08 to 1.22). The current evidence suggests that levosimendan is not associated with significantly reduced mortality in patients with reduced ejection fraction undergoing cardiac surgery.
       
  • Sedation with dexmedetomidine prolongs the analgesic duration of brachial
           plexus block: a randomised controlled trial
    • Abstract: Publication date: Available online 16 October 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Boohwi Hong, Choonho Jung, Yumin Jo, Hyemin Kang, Woosuk Chung, Yoon-Hee Kim, ChaeSeong Lim, YoungKwon Ko PurposeDexmedetomidine, an alpha 2 receptor agonist, prolongs nerve block duration when administered in conjunction with peripheral nerve blocks. We hypothesised that sedation with dexmedetomidine could also significantly prolong the analgesic duration of brachial plexus block (BPB) during orthopaedic surgery on the upper extremities.Materials and methodsOne hundred and two patients received upper extremity surgery under BPB. The patients were randomly sedated with dexmedetomidine (D group) or midazolam (M group) following BPB using 25 mL of local anaesthetics (1:1 mixture of 1% lidocaine and 0.75% ropivacaine). Adequate sedation was evaluated with the modified Ramsay Sedation Scale. Primary outcome was measured as the time the patient first requested analgesic via a patient-controlled analgesia device. Total opioid consumption during the first 24 post-operative hours was also measured as secondary outcomes.ResultsTime to first request for analgesia (mean ± standard deviation) was significantly longer in the D group (616.9 ± 158.2 min) than in the M group (443.7 ± 127.2 min) (P 
       
  • Should we still prescribe Levosimendan for low cardiac output after
           cardiac surgery' Perhaps in the good patients!
    • Abstract: Publication date: Available online 9 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Prof. Romain Pirracchio
       
  • CON: Levosimendan should be used in clinical practice for patients with
           significantly impaired left ventricular function undergoing cardiac
           surgery
    • Abstract: Publication date: Available online 9 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Nick Fletcher Dr
       
  • AUGMENTED RENAL CLEARANCE: A REAL PHENOMENON WITH AN UNCERTAIN CAUSE
    • Abstract: Publication date: Available online 9 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): João Pedro Baptista, Jason A. Roberts, Andrew A. Udy
       
  • French Guidelines of Paediatric Airway Management: Job Done'
    • Abstract: Publication date: Available online 5 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Thomas Engelhardt
       
  • Antibioprophylaxis in surgery and interventional medicine. (adult
           patients) Update 2017
    • Abstract: Publication date: Available online 2 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): C. Martin, C. Auboyer, M. Boisson, H. Dupont, R. Gauzit, M. Kitzis, M. Leone, A. Lepape, O. Mimoz, P. Montravers, J.L. PourriatSummaryInfection is a risk for any intervention. In surgery, for example, pathogenic bacteria are found in more than 90% of operative wounds during closure. This exists whatever the surgical technique and whatever the environment (the laminar flow does not entirely eliminate this risk). These bacteria are few in number but can proliferate. They find in the operative wound a favourable environment (haematoma, ischaemia, modification of oxido-reduction potential…) and the intervention induces anomalies of the immune defences. In the case of the installation of foreign material, the risk is increased. The objective of antibiotic prophylaxis (ABP) is to prevent bacterial growth in order to reduce the risk of infection at the site of the intervention. The preoperative consultation represents a privileged moment to decide on the prescription of a ABP. It is possible to define the type of intervention planned, the associated risk of infection (and therefore the necessity or not of ABP), the time of prescription before surgery and any allergic antecedents which may modify the choice of the selected antibiotic molecule.
       
  • PHARMECMO: Therapeutic drug monitoring and adequacy of current dosing
           regimens of antibiotics in patients on Extracorporeal Life Support
    • Abstract: Publication date: Available online 1 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Adrien Bouglé, Olivier Dujardin, Victoria Lepère, Nora Ait Hamou, Charles Vidal, Guillaume Lebreton, Joe-Elie Salem, Najoua El-Helali, Grégoire Petijean, Julien Amour
       
  • Impact of hypnosis on patient experience after venous access port
           implantation
    • Abstract: Publication date: Available online 1 March 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Laura Hoslin, Cyrus Motamed, Maurice-Szamburski Axel, Clemence Legoupil, Stephanie Pons, Lauriane Bordenave Introduction : Hypnosis has been reported to decrease pain and anxiety in surgical context, but data studying its impact on patient experience using a validated scale are scarce. In the present study, we assessed the effect of an audio hypnosis session on patient satisfaction during venous access port implantation under local anaesthesia in adult cancer patients using the EVAN-LR score.Methods: After informed consent, patients were randomized to receive either hypnosis or standard care. The hypnosis group listened to a 26 minutes recorded audio hypnosis session through the ongoing implantation procedure.The primary outcome was the result of the EVAN-LR questionnaire, assessing perioperative experience in patients undergoing anaesthesia without loss of consciousness. This score describes a global index and 5 dimensions of experience: comfort, pain attention, information and waiting. It is scaled from 0 to 100 with 100 indicating the best possible level of satisfaction. Secondary outcomes included patient’s anxiety, heart rate before and after procedure, procedure duration and several Visual Analogic Scale to match EVAN-LR dimensions.Results: Overall, 148 patients were enrolled in the study. The global index of Evan-LR was significantly higher in the hypnosis session group (78 ± 14) compared to the standard care group (71 ± 17) (p = 0.006). No difference was reported in secondary outcomes.Conclusion: A recorded audio hypnosis session during subcutaneous venous port implantation under local anaesthesia in cancer patients significantly improved patient satisfaction.
       
  • A French version of Ringsted's questionnaire on pain-related impairment of
           daily activities after lung surgery: a cohort study
    • Abstract: Publication date: Available online 28 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Jean-François Dreyfus, Aicha Kassoul, Mireille Michel-Cherqui, Marc Fischler, Morgan Le Guen Background: The questionnaire from Ringsted et al. (RQ) assesses the consequences on daily activities of a post − thoracotomy pain syndrome. Our study aimed at translating the RQ into French and to validate its metrological properties.Methods: Four months after thoracotomy, 134 patients participating in a prospective comparative study of two surgical thoracotomy approaches (axillary and posterolateral) scored the translated questionnaire. The sensitivity of this version was assessed by comparing scores from patients complaining of pain to that of non-complainers. Concurrent validity was assessed using ratings from direct questions on pain, mood, anxiety and enjoyment of life. Homogeneity was assessed with Crombach's coefficient and dimensionality with PCA.Results:A scoring system was devised to homogenise pain-related impairment with activities that were never performed before surgery and activities that had to be abandoned due to pain. The French version is bi-dimensional: routine activities (carrying heavy loads, raising the arms above the head, housework, getting out of bed, car driving, lying on the operated side, coughing, sitting for half an hour) are opposed to running, walking 1 km, climbing stairs, bending knees, standing for half an hour, swimming and cycling; both these factors contribute independently to the global score. Global and factor scores are sensitive to presence of pain while direct questions account for 20 to 50 % of the information provided by the questionnaire.Conclusion:The French version of the RQ is suitable to assess chronic repercussions of lung surgery on the ability of patients to perform their daily activities.
       
  • Revision of Expert Panel’s Guidelines on Postoperative Pain
           Management
    • Abstract: Publication date: Available online 26 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Frédéric Aubrun, Karine Nouette-Gaulain, Dominique Fletcher, Anissa Belbachir, Hélène Beloeil, Michel Carles, Philippe Cuvillon, Christophe Dadure, Gilles Lebuffe, Emmanuel Marret, Valeria Martinez, Michel Olivier, Nada Sabourdin, Paul Zetlaoui The French Society of Anaesthesia and Intensive Care Medicine (SFAR) published experts’ guidelines on the care of postoperative pain. This was an update of the 2008 guidelines. Fourteen experts analysed the literature (PubMed™, Cochrane™) on questions that had not been treated in the previous guidelines, or to modify the guidelines following new data in the published literature. The used method is invariably the GRADE© method, which guarantees a rigorous work. Seventeen recommendations were formalised on the assessment of perioperative pain, and most particularly in non-communicating patients, on opioid and non-opioid analgesics and on anti-hyperalgesic drugs, such as ketamine and gabapentinoids, as well as on local and regional anaesthesia. The concept of vulnerability and therefore the identification of the most fragile patients in terms of analgesics requirements were specified. Because of the absence of sufficient data or new information, no recommendation was made about analgesia monitoring, the procedures for the surveillance of patients in conventional care structures, or perinervous or epidural catheterism.
       
  • Ketamine infusion for sedation in ICU, Response to Dr Mion
    • Abstract: Publication date: Available online 26 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Perbet Sebastien, Godet Thomas, Constantin Jean-Michel
       
  • Sugammadex for reversal of neuromuscular blockade in paediatric patients:
           a two-year single-centre retrospective study
    • Abstract: Publication date: Available online 25 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): A. Simonini, E. Brogi, M.G. Calevo, M. Carron
       
  • Do observers and active participants learn similarly during high fidelity
           sessions'
    • Abstract: Publication date: Available online 25 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): A Blanie, D Benhamou
       
  • EFFECTS OF MODIFICATION OF TRAUMA BLEEDING MANAGEMENT: A BEFORE AND AFTER
           STUDY
    • Abstract: Publication date: Available online 23 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Cécile Guth, Olivia Vassal, Arnaud Friggeri, Pierre-François Wey, Kenji Inaba, Evelyne Decullier, François-Xavier Ageron, Jean-Stéphane David ObjectiveWe hypothesised that the association of tranexamic acid (TXA) administration and thromboelastometry-guided haemostatic therapy (TGHT) with implementation of Damage Control Resuscitation (DCR) reduced blood products (BP) use and massive transfusion (MT).MethodsRetrospective comparison of 2 cohorts of trauma patients admitted in a university hospital, before (Period 1) and after implementation of DCR, TXA (first 3-hours) and TGHT (Period 2). Patients were included if they received at least 1 BP (RBC, FFP or platelet) or coagulation factor concentrates (fibrinogen or prothrombin complex) during the first 24-hours following the admission.Results380 patients were included. Patients in Period 2 (n = 182) received less frequently a MT (8% vs. 33%, p 
       
  • Management of Malignant Hyperthermia in France: current organisation
    • Abstract: Publication date: Available online 23 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Florence Julien-Marsollier, Nathalie Roux-Buisson, Anne-Frederique Dalmas, Beatrice Bruneau, Souhayl Dahmani
       
  • Answer to the reply letter to: Physician’s experience in decisions of
           withholding, withdrawing life-sustaining treatments: a multicentre survey
           in emergency departments
    • Abstract: Publication date: Available online 23 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): DOUPLAT Marion, JACQUIN Laurent, TAZAROURTE Karim, LE COZ Pierre
       
  • MANAGEMENT OF THE CHILD’S AIRWAY UNDER ANAESTHESIA: THE FRENCH
           GUIDELINES
    • Abstract: Publication date: Available online 23 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Christophe Dadure, Nada Sabourdin, Francis Veyckemans, Florence Babre, Nathalie Bourdaud, Souhayl Dahmani, Mathilde De Queiroz, Jean-Michel Devys, Marie-Claude Dubois, Delphine Kern, Anne Laffargue, Marc Laffon, Corinne Lejus-Bourdeau, Karine Nouette-Gaulain, Gilles Orliaguet, Etienne Gayat, Lionel Velly, Nadège Salvi, Chrystelle Sola OBJECTIVE:To provide French guidelines about "Airway management during paediatric anaesthesia".DESIGN:A consensus committee of 17 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d’Anesthésie-Réanimation, SFAR) and the Association of French speaking paediatric anaesthesiologists and intensivists (Association Des Anesthésistes Réanimateurs Pédiatriques d’Expression Francophone, ADARPEF) was convened. The entire process was conducted independently of any industry funding. The authors followed the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to assess the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Few recommendations were not graded.METHODS:The panel focused on 7 questions: 1) Supraglottic Airway devices 2) Cuffed endotracheal tubes 3) Videolaryngoscopes 4) Neuromuscular blocking agents 5) Rapid sequence induction 6) Airway device removal 7) Airway management in the child with recent or ongoing upper respiratory tract infection. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the redaction of the recommendations were then conducted according to the GRADE® methodology.RESULTS:The SFAR Guideline panel provides 17 statements on “airway management during paediatric anaesthesia”. After two rounds of discussion and various amendments, a strong agreement was reached for 100% of the recommendations. Of these recommendations, 6 have a high level of evidence (Grade 1 ± ), 6 have a low level of evidence (Grade 2 ± ) and 5 are experts’ opinions. No recommendation could be provided for 3 questions.CONCLUSIONS:Substantial agreement exists among experts regarding many strong recommendations for paediatric airway management.
       
  • Low interleukin-10 release after ex vivo stimulation of whole blood is
           associated with persistent organ dysfunction in sepsis: a prospective
           observational study
    • Abstract: Publication date: Available online 21 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Nicolas NESSELER, Corinne MARTIN-CHOULY, Harmonie PERRICHET, James T. ROSS, Chloé ROUSSEAU, Pratik SINHA, Sonia ISSLAME, Elodie MASSERET, Yannick MALLÉDANT, Yoann LAUNEY, Philippe SEGUIN Background: Sepsis profoundly alters immune homeostasis. Cytokine release after whole blood lipopolysaccharide (LPS)-stimulation reflects cell function across multiple immune cell classes and represents the immune response to LPS. The main goal of this study was to evaluate the prognostic value of ex vivo stimulation of whole blood with LPS in sepsis.Methods: Blood was drawn on day 1 and day 7 after admission, and stimulated ex vivo with LPS. Tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and IL-10 were measured with and without stimulation. Our primary outcome measure was the persistence of at least one organ dysfunction at day 7. Organ dysfunction was defined according to the SOFA components by a score> = 2.Results: Forty-nine patients with sepsis from a 21-bed intensive care unit, and 23 healthy volunteers were enrolled. The blood of septic patients was less responsive to ex vivo stimulation with LPS than that of healthy controls at day 1 and 7, as demonstrated by lower TNF-α, IL-1β, IL-6 and IL-10 release. Persistent organ dysfunction was more frequent in patients with lower IL-10 release at day 1 but such an association was not found for pro-inflammatory cytokines. A persistent low IL-10 release at day 7 was also associated with persistent organ dysfunction.Conclusion: These data suggest that the capacity to produce IL-10 in response to whole blood ex vivo stimulation early in sepsis, as well as persistent low IL-10 response over time, may help in prognostication and patient stratification. These results will need to be confirmed in future studies.
       
  • Diagnosis of brain death, back to medical diagnosis!
    • Abstract: Publication date: Available online 14 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Julien CHARPENTIER
       
  • Prophylactic hypothermia for traumatic brain injury patients: It’s
           not cool to be, cooled
    • Abstract: Publication date: Available online 11 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Véronique Vermeersch, Olivier Huet
       
  • Implementation of trauma systems: not inventing the wheel over and over
           again!
    • Abstract: Publication date: Available online 8 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Marc Maegele, Samuel M. Galvagno
       
  • Interchangeability of cardiac output measurements between oesophageal
           Doppler and pulse contour analysis is dependent on stroke volume
    • Abstract: Publication date: Available online 5 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Emmanuel Lorne, Marc-Olivier Fischer
       
  • Prophylaxis for stress related gastrointestinal bleeding in the ICU:
           Should we adjust to each patient’s individual risk'
    • Abstract: Publication date: Available online 5 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Jean-Pierre Quenot, Auguste Dargent, Alan Barkun, Marc Bardou
       
  • Reply letter to: Physician’s experience in decisions of withholding and
           withdrawing life-sustaining treatments: A multicenter survey in emergency
           departments
    • Abstract: Publication date: Available online 5 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Antoine Lamblin, Clement Derkenne
       
  • Therapeutic hypothermia after traumatic brain injury: wrong hypotheses may
           lead to specious interpretations
    • Abstract: Publication date: Available online 5 February 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Pierre Bouzat, Jean-François Payen
       
  • Opioid free anaesthesia: myth or reality'
    • Abstract: Publication date: Available online 18 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): H. HARKOUK, D. FLETCHER, H. BELOEIL
       
  • Caring for severe trauma patients in France. A call for a national
           strategy'
    • Abstract: Publication date: Available online 18 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Jérémy GUENEZAN, Nicolas MARJANOVIC, Bertrand DRUGEON, Olivier MIMOZ
       
  • REPLY TO THE LETTER TO THE EDITOR
    • Abstract: Publication date: Available online 11 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Joseph Rinehart, PhilippeVan der Linden, Alexandre Joosten
       
  • Severe Patient Injury Associated with Mechanical Ventilators: A
           “Never Event”
    • Abstract: Publication date: Available online 10 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Karen B. Domino
       
  • Haemoperfusion with polymyxin B membrane: Recent results for an old
           debate!
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Didier Payen
       
  • Brain death: Bilateral pneumothorax and pneumoperitoneum after an apnoea
           test
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): G. Thery, J. Rosman, G. Julien, F. Chaix, P. Mateu
       
  • Oxygen through suction port: use of a three way stopcock during fiberoptic
           bronchoscopy
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Amarjeet Kumar, Neeraj Kumar, Chandni Sinha
       
  • Transverse subglottic diameter assessment in the third gestation
           trimester: Preeclampsia versus control
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Olivier Belin, Fabien Espitalier, Francis Remerand, Franck Perrotin, Marc Laffon
       
  • Herpes simplex virus: A rare but treatable cause of fulminant hepatitis
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): V. Guillotin, S. De Guillebon, N. Bui, C. Sazio, A. Boyer
       
  • Anaesthesia management by residents does not alter the incidence of
           self-reported anaesthesia awareness: A teaching hospital-based propensity
           score analysis
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Aya Takechi, Satoki Inoue, Masahiko Kawaguchi BackgroundIntraoperative awareness during general anaesthesia is rare but represents one of the major anaesthesia-related complications. Intraoperative awareness may be a result of inadequate anaesthesia management. Therefore, the incidence can be related with the experience of anaesthetists. To assess whether the incidence of intraoperative awareness is related to anaesthetists’ experience, we compared the incidence of self-reported intraoperative awareness between patients managed by anaesthesia residents or by experienced anaesthetists.MethodsThis is a retrospective review of an institutional registry containing 21,606 general anaesthesia cases. It was conducted with the ethics board approval. Propensity score analysis was used to generate a set of matched cases (resident managements) and controls (anaesthetist managements), yielding 4940 matched patient pairs. The incidence of self-reported intraoperative awareness compared as primary outcomes. Additionally, a multivariate logistic analysis in the entire cohort, using the incidence of self-reported intraoperative awareness as dependent variable, was conducted to confirm the result of the primary outcome.ResultsIn the unmatched population, contrary to our hypothesis, the incidence of self-reported intraoperative awareness was lower in resident management compared with anaesthetist management (1.1% vs. 1.5%, P = 0.028). However, after propensity score matching, there was no difference in incidences of self-reported intraoperative awareness (1.5% vs. 1.3%, 0.38). The multivariate analysis confirmed the result of the primary outcome from the matched pair analysis and showed that ASA physical status (OR = 1.40, 95% CI = 1.08 to 1.81), emergency case (CI = 2.05, 95% CI = 1.40 to 3.00), and application of postoperative analgesia (OR = 0.70, 95% CI = 0.50 to 0.97) were independently associated with incidence of self-reported intraoperative awareness.ConclusionIn conclusion, when supervised by an anaesthetist, resident anaesthesia management is not more likely to result in complaints about intraoperative recall than anaesthetist management.
       
  • Male requires a higher median target effect-site concentration of propofol
           for I-gel placement when combined with dexmedetomidine
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): M.-M. Han, F.-S. Xue, F. Kang, X. Huang, J. Li ObjectiveThe supraglottic airway device (SAD) can be used for airway management of spontaneous breathing patients, and propofol is commonly applied for the SAD placement. This study was designed to assess the effect of gender on median target effect-site concentration (Ce50) of propofol for I-gel placement when combined with dexmedetomidine.Material and method19 males and 18 females, aged 18 to 59 and undergoing elective surgery, were enrolled. After intravenous infusion of dexmedetomidine 1.0 μg/kg over 10 min followed by continuous infusion of 0.4 μg/kg/h, target-controlled infusion of propofol under Marsh model was started and the initial Ce of propofol was set at 4.79 μg/mL and 4.35 μg/mL in the male and female patients, respectively. The I-gel was inserted when the Ce of propofol reached the pre-set concentration and bispectral index value was less than 60. The Ce of propofol required for I-gel placement was determined by the Dixon up-and-down method.ResultsThe Ce50 (95% confidence interval) of propofol required for I-gel placement were 4.082 μg/mL (3.798–4.332 μg/mL) and 3.509 μg/mL (3.266–3.749 μg/mL) in male and female patients, respectively, with a significantly higher Ce50 in males.ConclusionWhen combined with dexmedetomidine, males require a higher Ce50 of propofol for I-gel placement compared to females.
       
  • Comparison of the acoustic windows for the thoracic paramedian epidural
           approach after shoulder rotation: The lateral decubitus versus the sitting
           position
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Hyo-Jin Byon, Sung-Jun Hong, Dae-Yu Kim, Joo-Hyeon O, In-Gon Lee, Dong-Ho Seo, Gyoung-A. Heo, Hyunzu Kim BackgroundThe aim of this study was to compare the mean lengths of the posterior longitudinal ligament (PLL) as the acoustic window during the thoracic paramedian epidural approach after shoulder rotation, while subjects were in the lateral decubitus or in the sitting position.MethodsThirty-two adult male volunteers were placed in the right decubitus position or sitting position on a horizontal operating table. To obtain an optimal ultrasound view for the PLL on the right side, thoracic spinal ultrasonography was performed at the T6/7 interspace using the paramedian oblique sagittal plane. PLL length was measured on the ultrasound image before and after right shoulder rotation.ResultsBefore shoulder rotation, the difference in mean PLL length between the sitting (11.1 ± 1.3 mm) and lateral decubitus (10.7 ± 1.2 mm) positions was not statistically significant (P = 0.05). Within-position, the before and after comparison revealed that after shoulder rotation, PLL length was significantly increased to 12.2 ± 1.4 mm (P 
       
  • The efficacy of ultrasound-guided type-I and type-II pectoral nerve blocks
           for postoperative analgesia after breast augmentation: A prospective,
           randomised study
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Omer Karaca, Huseyin U. Pınar, Enver Arpacı, Rafi Dogan, Oya Y. Cok, Ali Ahiskalioglu PurposeThe present study was planned to evaluate the efficacy and safety of ultrasound-guided Pecs I and II blocks for postoperative analgesia after sub-pectoral breast augmentation.MethodsFifty-four adult female patients undergoing breast augmentation were randomly divided into two groups: the control group (Group C, n = 27) who were not subjected to block treatment and Pecs group (Group P, n = 27) who received Pecs I (bupivacain 0.25%, 10 mL) and Pecs II (bupivacain 0.25%, 20 mL) block. Patient-controlled fentanyl analgesia was used for postoperative pain relief in both groups, and the patients were observed for the presence of any block-related complications.ResultsThe 24-h fentanyl consumption was smaller in Group P [mean ± SD, 378.7 ± 54.0 μg and 115.7 ± 98.1 μg, respectively; P 
       
  • Postoperative analgesic efficacy of ultrasound-guided
           ilioinguinal-iliohypogastric nerve block compared with medial transverse
           abdominis plane block in inguinal hernia repair: A prospective, randomised
           trial
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Nidhi Bhatia, Indu Mohini Sen, Banashree Mandal, Ankita Batra PurposeAnalgesic efficacy of ultrasound-guided transverse abdominis plane block, administered a little more medially, just close to the origin of the transverse abdominis muscle has not yet been investigated in patients undergoing unilateral inguinal hernia repair. We hypothesised that medial transverse abdominis plane block would provide comparable postoperative analgesia to ilioinguinal-iliohypogastric nerve block in inguinal hernia repair patients.MethodsThis prospective, randomised trial was conducted in 50 ASA I and II male patients ≥ 18 years of age. Patients were randomised into two groups to receive either pre-incisional ipsilateral ultrasound-guided ilioinguinal-iliohypogastric nerve block or medial transverse abdominis plane block, with 0.3 ml/kg of 0.25% bupivacaine. Our primary objective was postoperative 24-hour analgesic consumption and secondary outcomes included pain scores, time to first request for rescue analgesic and side effects, if any, in the postoperative period.ResultsThere was no significant difference in the total postoperative analgesic consumption [group I: 66.04 mg; group II: 68.33 mg (P value 0.908)]. Time to first request for rescue analgesic was delayed, though statistically non-significant (P value 0.326), following medial transverse abdominis plane block, with excellent pain relief seen in 58.3% patients as opposed to 45.8% patients in ilioinguinal-iliohypogastric nerve block group.ConclusionMedial transverse abdominis plane block being a novel, simple and easily performed procedure can serve as an useful alternative to ilioinguinal-iliohypogastric nerve block for providing postoperative pain relief in inguinal hernia repair patients.
       
  • A new national quality indicator reflecting pain relief in the PACU has
           been launched and initial results show the positive performance of French
           teams
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Dan Benhamou, Claude Ecoffey, Sophie Calmus, Fréderic Capuano, Marc Dahlet, Arnaud Fouchard
       
  • Acute liver failure: Running fast between the traps
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Jean-Marc Delay, Audrey de Jong, Catherine Paugam-Burtz, Emmanuel Weiss
       
  • Perioperative haemodynamic therapy: Why are recommendations not being
           adopted'
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Matthieu Biais, Rupert Pearse
       
  • Evaluation of locum tenens activity by young anaesthesiologists and
           intensivists: A national survey
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Michael Thy, Jean Bardon, Hélène Carbonne
       
  • A cure for septic AKI: Why not keep the dream alive'
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Thibault Michel, Olivier Joannes-Boyau, Antoine-Guillaume Schneider
       
  • Ultrasound-guided bilateral erector spinae plane block could provide
           effective postoperative analgesia in laparoscopic cholecystectomy in
           paediatric patients
    • Abstract: Publication date: February 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 1Author(s): Can Aksu, Yavuz Gürkan
       
  • DATA QUALITY AND BLOCKCHAIN TECHNOLOGY
    • Abstract: Publication date: Available online 8 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Valentina Bellini, Alberto Petroni, Giuseppina Palumbo, Elena Bignami
       
  • A new SFAR / APSF collaboration: another step towards the common goal of
           patient safety
    • Abstract: Publication date: Available online 8 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): A Theissen, X Capdevila, MA Warner, SB Greenberg, P Trouiller
       
  • Optimal amount of calories for critically ill patient
    • Abstract: Publication date: Available online 8 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Thomas LESCOT, Jean Charles PREISER
       
  • Active participation in high fidelity simulation might be associated with
           higher stress level and better learning outcomes at three months than
           external observation
    • Abstract: Publication date: Available online 8 January 2019Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Marc Lilot, Jean-Noël Evain, Antoine Duclos, Jean-Jacques Lehot, Thomas Rimmelé
       
  • Bleeding complications following peripheral regional anaesthesia in
           patients treated with anticoagulants or antiplatelet agents: a systematic
           review
    • Abstract: Publication date: Available online 23 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): F Joubert, P Gillois, H Bouaziz, E Marret, G Iohom, P Albaladejo Background:Patients on either antiplatelet or anticoagulant therapy may need procedures performed under peripheral nerve blocks in preference to general anaesthesia techniques. The risk of bleeding associated with peripheral nerve blocks under these circumstances remains unknown. This systematic review evaluates the incidence of bleeding complications following peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication.Method:All English, French and Spanish publications on peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication, from 1978 to 2018 from various sources including Pubmed, were reviewed. Publications on neuraxial anaesthesia (spinal or epidural) and eye blocks were excluded.Results:Twenty-four articles were selected, including six observational studies and 18 case reports. Patients received antiplatelet agents only, in 4 studies, anticoagulants only in 14 studies, and both in 6 studies. In the observational studies, 80 bleeding complications (haematoma or minor bleeding at the puncture site) were identified following 9.738 peripheral nerve blocks. Amongst case reports, 15 bleeding complications were noted following 50 peripheral nerve blocks. Bleeding complications were reported mostly with lumbar plexus blocks (1 requirement for blood transfusion, 1 catheter embolization, 1 surgical exploration and 1 death). The overall estimate of the incidence of bleeding complications was 0.82% (0.64%-1.0%).Conclusion: This systematic review found that bleeding complications following peripheral nerve blocks were rare in patients receiving antiplatelet and/or anticoagulant medication.
       
  • Etomidate-induced hypotension: a pathophysiological approach using
           arterial elastance
    • Abstract: Publication date: Available online 21 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Osama Abou Arab, Marc Olivier Fischer, Alexis Carpentier, Christophe Beyls, Pierre Huette, Abdel Hchikat, Amar Benammar, Beatris Labont, Yazine Mahjoub, Stéphane Bar, Pierre-Grégoire Guinot, Emmanuel Lorne Introduction: Anaesthesia frequently induces hypotension. Several recent studies have analysed arterial elastance (Ea) in order to describe clinical variations of mean arterial pressure (MAP). The objective of the study was to assess Ea to explain MAP variation following etomidate induction.Methods: We conducted a prospective single-centre study. Inclusion criteria were patients undergoing elective cardiac surgery with invasive blood pressure monitoring. Ea was expressed as Pes/SV (Pes: end systolic pressure, SV: stroke volume). Cardiac index (CI), peripheral vascular resistance (PVR) and arterial compliance (C) was compared before and 2 minutes after etomidate induction. Arterial hypotension was defined as a decrease greater than 15% of the baseline MAP.Results: Of the 45 patients included, 24 (53%) had a preserved MAP and 21 (47%) had an etomidate-induced hypotension. Ea was similar before induction and decreased in the decreased MAP group 2 minutes after induction (2.0 mmHg.ml-1 [1.7-2.4] vs 1.4 mmHg.ml-1 [0.9-1.9]; p = 0.001). Arterial compliance (C) increased in the decreased MAP group 2 minutes after induction (0.8 ml. mmHg-1 [0.6-1.0] vs 0.5 ml. mmHg-1 [0.4-0.6], p 
       
  • EARLY MANAGEMENT OF SEVERE PELVIC INJURY (FIRST 24 HOURS)
    • Abstract: Publication date: Available online 21 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Pascal Incagnoli, Alain Puidupin, Sylvain Ausset, Jean Paul Beregi, Jacques Bessereau, Xavier Bobbia, Julien Brun, Elodie Brunel, Clément Buléon, Jacques Choukroun, Xavier Combes, Jean Stephane David, François-Régis Desfemmes, Delphine Garrigue, Jean-Luc Hanouz, Isabelle Plénier, Fréderic Rongieras, Benoit Vivien, Tobias Gauss, Anatole Harrois OBJECTIVE:Pelvic fractures represent 5% of all traumatic fractures and 30% are isolated pelvic fractures. Pelvic fractures are found in 10 to 20% of severe trauma patients and their presence is highly correlated to increasing trauma severity scores. The high mortality of pelvic trauma, about 8 to 15%, is related to actively bleeding pelvic injuries and/or associated injuries to the head, abdomen or chest. Regardless of the severity of pelvic trauma, diagnosis and treatment must proceed according to a strategy that does not delay the management of the most severely injured patients. To date, in France, there are no guidelines issued by healthcare authorities or professional societies that address this subject.DESIGN:A consensus committee of 22 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d’Anesthésie et de Réanimation ; SFAR) and the French Society of Emergency Medicine (Société Française de Médecine d’Urgence ; SFMU) in collaboration with the French Society of Radiology (Société Française de Radiologie ; SFR), French Defence Health Service (Service de Santé des Armées ; SSA), French Society of Urology (Association Française d’Urologie ; AFU), the French Society of Orthopaedic and Trauma Surgery (Société Française de Chirurgie Orthopédique et Traumatologique ; SOCFCOT), and the French Society of Digestive Surgery (Société Française de Chirurgie digestive ; SFCD) was convened. A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently from any industry funding. The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised.METHODS:Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the recommendations were then conducted according to the GRADE® methodology.RESULTS:The SFAR Guideline panel provided 22 statements on prehospital and hospital management of the unstable patient with pelvic fracture. After three rounds of discussion and various amendments, a strong agreement was reached for 100% of recommendations. Of these recommendations, 11 have a high level of evidence (Grade 1 ± ), 11 have a low level of evidence (Grade 2 ± ).CONCLUSIONS:Substantial agreement exists among experts regarding many strong recommendations for management of the unstable patient with pelvic fracture.
       
  • The effect of playing video games on fiberoptic intubation skills
    • Abstract: Publication date: Available online 21 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Aysun Ankay Yilbas, Ozgur Canbay, Basak Akca, Filiz Uzumcugil, Asli Melek, Mert Calis, İbrahim Vargel Introduction:The effect on hand-eye coordination and visuospatial skills made videogames popular for training in laparoscopic surgery. Although similar effects may be true for fiberoptic intubation (FOI), it hasn’t been studied before. The aim of this study was to investigate the effect of playing videogames with gamepad on FOI skills.Methods: After obtaining ethical approval and informed consent, 36 anaesthesia residents with no experience on fiberoptic intubation were divided into two groups. Group C (n = 18) consisted of the residents without any videogame experience with gamepad. Group PS (n = 18) played a videogame 30 minutes/day for five days. All residents performed their first nasal FOI on a patient undergoing orthognathic surgery with no known difficult intubation under general anaesthesia under supervision of an experienced anaesthesiologist. Intubation time, success rate, pre- and post-intubation SpO2 and etCO2 values were recorded.Results:Intubation time was shorter (p = 0,017) and success rate at the first attempt was higher in Group PS (p = 0,045) compared to Group C. We performed multivariate linear regression analysis to investigate which independent variables (gender of residents, experience in anaesthesiology, dominant hand, study group and previous history of videogame experience) affected our dependent variable intubation time. Backward analysis revealed previous videogame playing history (previous players vs. non-players) was the only significant predictor of intubation time (p = 0.010).Conclusion:Although we cannot reliably suggest using videogames as an educational tool for FOI, the results of our study showed that videogame playing history may provide an improvement in FOI time of novices in actual operating-theatre environment.
       
  • Is variability a natural phenomenon in patients, providers and
           institutions'
    • Abstract: Publication date: Available online 21 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Rashid Nadeem, Jawed Shafaq
       
  • Augmented renal clearance in critically ill trauma patients:a
           pathophysiologic approach using renal vascular index
    • Abstract: Publication date: Available online 21 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): CEDRIC CARRIE, ALEXANDRE LANNOU, SEBASTIEN RUBIN, HUGUES DE COURSON, LAURENT PETIT, MATTHIEU BIAIS BACKGROUND:The aim of the present study was to explore the relationship between creatinine clearance (ClCr), cardiac index (CI) and renal vascular index (RVI) in order to assess the potential mechanisms driving ARC in critically ill trauma patient. The secondary objective was to assess the performance of RVI for prediction of ARC.METHODS:Every trauma patient who underwent cardiac and renal ultrasound measurements during their initial ICU management was retrospectively reviewed over a 3-month period. ARC was defined by a 24-hr measured CrCL ≥ 130 ml/min/1.73m². A mixed effect model was constructed to explore covariates associated with ClCr over time. The performance of RVI for prediction of ARC was assessed by receiver operating characteristic (ROC) curve and compared to the ARCTIC (ARC in trauma intensive care) predictive scoring model.RESULTS:Thirty patients, contributing for 121 coupled physiologic data, were retrospectively analysed. There was a significant correlation between ClCr values and RVI (r = -0.495; p = 0.005) but not between ClCr and CI values (r = 0.023; p = 0.967) at day 1. Using a mixed effect model, only age remained associated with ClCr variations over time. The area under the ROC curve of RVI for predicting ARC was 0.742 (95%CI: 0.649 - 0.834; p 
       
  • Sensory selective peripheral nerve block for wide-awake surgery
    • Abstract: Publication date: Available online 18 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Subin Yoo, Seunguk Bang, Sang-Eun Park
       
  • [TIMP-2]*[IGFBP7] for Predicting Early AKI
    • Abstract: Publication date: Available online 18 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Ankit Luthra, Asha Tyagi
       
  • Immediate haemodynamic impact response to a mini-fluid challenge is
           independent of fluid type: a post-hoc analysis of a randomised double
           blinded controlled trial
    • Abstract: Publication date: Available online 18 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Alexandre Joosten, Amelie Delaporte, Philippe Van der Linden, Joseph Rinehart, Brian Hipszer
       
  • Ketamine infusions for sedation in ICU
    • Abstract: Publication date: Available online 15 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Georges Mion
       
  • T-cell lymphoma with secondary hemophagocytic lymphohistiocytosis as a
           rare cause of acute liver failure T-cell lymphoma as a cause of acute
           liver failure
    • Abstract: Publication date: Available online 13 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Yasmina CHOUIK, BLAISE Lorraine, HACHOUF Marina, GIABICANI Mikhaël, ROUX Olivier
       
  • Blood pressure variability in surgical and intensive care patients: Is
           there a potential for closed-loop vasopressor administration'
    • Abstract: Publication date: Available online 1 December 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Joseph Rinehart, Michael Ma, Michael David Calderon, Aurelie Bardaji, Reda Hafiane, Philippe Van der Linden, Alexandre Joosten Blood pressure management in the operating rooms (OR) and intensive care units (ICU) frequently involves manually titrated vasopressor therapy to an optimal range of mean arterial pressure (MAP). Ideally, changes in vasopressor infusion rates have to quickly follow variations in blood pressure measurements. However, such a tightly controlled feedback loop is difficult to achieve. Few studies have examined blood pressure control when vasopressor therapy is administered manually in OR and ICU patients. We extracted MAP data from 3,623 patients (2,530 from the ORs and 1,093 from the ICU) on vasopressors from our electronic medical records. Coefficient of variation (=standard deviation / mean value) * 100) was calculated and the values were additionally categorized into different MAP ranges (MAP 
       
  • ACUTE LIVER FAILURE AND MISDIAGNOSIS: DO NOT FORGET VIRAL HEPATITIS E
    • Abstract: Publication date: Available online 11 July 2018Source: Anaesthesia Critical Care & Pain MedicineAuthor(s): Thomas Laumon, Hélène Dietrich, Laurent Muller, C. Roger
       
 
 
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