French Survey of Anesthesia in 1996

Clergue, F.; Auroy, Yves; Péquignot, F; Jougia, Eric; Lienhart, A.; Laxenaire, M.C.

doi:10.1097/00132586-200010000-00059

Cited by 51 publications

(66 citation statements)

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“…A survey of anesthesia practice in France in 1996 has highlighted a 120% increase in number of anesthetics procedures since 1980, with a 14 fold increase in the number of regional anesthetic procedures [17]. Between 1990 and 1996, significant advances in knowledge and attitudes regarding pain and its management in the French general population occurred, with greater awareness of the importance of acute pain treatment and acceptance of morphine use [39].…”

Section: Introduction (491 Words)mentioning

confidence: 99%

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Fletcher

Fermanian

Mardaye

et al. 2008

Pain

250

133

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(249 words)We carried out a national survey on postoperative pain (POP) management in a representative sample (public/private, teaching/non teaching, size) of 76 surgical centers in France. Based on medical records and questionnaires, we evaluated adult patients 24 hours after surgery, concerning information, pre and postoperative pain, evaluation, treatment and side effects. A local consultant provided information about POP management. Data were recorded for 1900 adult patients, 69.3% of whom remembered information on POP.Information was mainly delivered orally (90.3%) and rarely noted on the patient's chart (18.2%). Written evaluations of POP were frequent on the ward (93.7%) with appropriate intervals (4.1 (4.0) hours), but not frequently prescribed (32.7%). Pain evaluations were based on visual analog scale (21.1%), numerical scale (41.2%), verbal scale (13.8%) or non numerical tool (24%). Pain was rarely a criterion for recovery room discharge (19.8%).Reported POP was mild at rest (2.7 (1.3), moderate during movement (4.9 (1.9) and intense at its maximal level (6.4 (2.0). Incidence of side effects was similar according to patient (26.4%) or medical chart (25.1%) including mostly nausea and vomiting (83.3%). Analgesia was frequently initiated during anesthesia (63.6%). Patient-controlled analgesia (21.4%) was used less frequently than subcutaneous morphine (35.1%) whose prescription frequently did not follow guidelines. Non-opioid analgesics used included paracetamol (90.3%), ketoprofen (48.5%) and nefopam (21.4%). Epidural (1.5%) and peripheral (4.7%) nerve blocks were underused. Evaluation (63.4%) or treatment (74.1%) protocols were not available for all patients.This national, prospective, patient-based, survey reveals both progress and persistent challenges in POP management.

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Section: Introduction (491 Words)mentioning

confidence: 99%

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Fletcher

Fermanian

Mardaye

et al. 2008

Pain

250

133

View full text Add to dashboard Cite

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“…B This rapid demographic shift will impact anesthesiologists and hospitals directly as it is estimated that one in three persons over the age of 65 will undergo an anesthetic procedure in any given year. 1 Regrettably, many of these surgical encounters will be complicated by disorders of cognitive function.…”

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confidence: 99%

Postoperative delirium: risk factors and management: Continuing Professional Development

Chaput

Bryson

2012

Can J Anesth/J Can Anesth

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Purpose Postoperative delirium often remains undiagnosed and therefore untreated. The purpose of this continuing professional development module is to identify patients at high risk of developing delirium following noncardiac surgery and to provide tools to aid in the diagnosis of delirium at the bedside. Optimal prevention and treatment strategies are recommended. Principal findings Delirium is characterized by an acute onset and a fluctuating course, inattention, disorganized thinking and an altered level of consciousness, and occurs in up to 40% of patients in the perioperative period. The pathophysiology of delirium is multifactorial, but it is believed to be related to inflammation, altered neurotransmission, and stress in the patient who has had surgery. Acetylcholine and dopamine appear to play a significant role. There is an increased risk of a poor outcome in patients who develop delirium, including a longer hospital stay and death. Surgical and patient factors play a significant role in predicting who will subsequently develop delirium. Prevention is much more effective than treatment in the management of delirium. The most effective prevention strategies include proactive geriatric assessment and care of the patient on a geriatrics surgical ward as well as prophylactic low-dose antipsychotic agents. From an anesthetic perspective, evidence in some surgical populations would support the use of regional techniques and minimal sedation. If delirium develops, treatment with lowdose oral antipsychotics appears to be most effective.Conclusions Delirium is a serious condition that must be recognized early and treated promptly to minimize deleterious outcomes. In order to institute prevention strategies and treat the condition effectively when it occurs, the anesthesiologist must be vigilant in identifying patients at risk and in screening for this condition. Objectives of this Continuing Professional Development (CPD) module:After reading this module, the reader should be able to:1. Define delirium in the context of other cognitive changes following non-cardiac surgery. 2. Understand the incidence and adverse outcomes associated with delirium. 3. List predisposing and precipitating factors of postoperative delirium and identify the patient at risk. 4. Explain the underlying pathophysiologic mechanisms believed to be implicated in causing delirium. 5. Formulate an anesthetic plan that minimizes the risk of developing postoperative delirium. 6. Devise a management plan to treat postoperative delirium most effectively while minimizing the adverse effects of treatment.Like other Western nations, Canada's population is aging rapidly. Over the past 50 years, the proportion of Canadians over the age of 65 has risen from 7.7% to 13.7%. A Statistics Canada estimates that the proportion of seniors will double 123Can J Anesth/J Can Anesth (2012) 59:304-320 DOI 10.1007 yet again by 2036 and will represent 23-25% of Canada's population. B This rapid demographic shift will impact anesthesiologists and hospitals ...

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“…En 1996, une enquête française ne rapportait que 8% d'intubation orotrachéale lors des AG pour manipulations utérines après l'accouchement. 3 Au Canada, une analyse des pratiques réalisée en 1998 montrait qu'environ 80% des AG pour révision utérine étaient réalisées sans intubation orotrachéale. 4 Depuis près de 10 ans, aucune autre étude n'a abordé ce sujet.…”

unclassified

Prise en charge des voies aériennes supérieures en obstétrique: enquête française de pratique

Zieleskiewicz

Bellefleur

Léone

2009

Can J Anesth/J Can Anesth

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French Survey of Anesthesia in 1996

Cited by 51 publications

References 0 publications

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges

Postoperative delirium: risk factors and management: Continuing Professional Development

Prise en charge des voies aériennes supérieures en obstétrique: enquête française de pratique

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