Anesthesia for endoscopic retrograde cholangiopancreatography: target-controlled infusion versus standard volatile anesthesia

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) is a technique used both for diagnosis and for the treatment of biliary and pancreatic diseases. ERCP has some anesthetic implications and specifi c complications. Th e primary outcome aim was to compare two protocols in terms of time of extubation. We also compared anesthetic protocols in terms of hemodynamic and respiratory instability, antispasmodics needs, endoscopist satisfaction, and recovery room stay

Anesthésie d’un greffé cardiaque en chirurgie non cardiaque: à propos d’un cas clinique et revue de la littérature

Le nombre et la durée de survie des patients transplantés cardiaque sont en augmentation. Une partie de ces patients se présentent régulièrement pour une chirurgie générale en dehors de la transplantation cardiaque. L’anesthésie chez ces patients peut être difficile en raison des particularités physiologiques du cœur dénervé et de la gestion du traitement immunosuppresseur avec le risque de rejet et d’infection. Nous discutons la prise en charge anesthésique à travers un cas d’un patient âgé de 60 ans transplanté cardiaque devant subir une chirurgie de cure d’éventration abdominale et une revue de la littérature. The Pan African Medical Journal. 2016;2

Moyamoya disease in a Moroccan baby: a case report

Abstract Background A stroke in a baby is uncommon, recent studies suggested that their incidence is rising. Moyamoya disease is one of the leading causes of stroke in babies. This condition is mostly described in Japan. In Morocco, moyamoya disease has rarely been reported and a few cases were published. We report a rare Moroccan case of a 23-month-old baby boy who presented with left-sided hemiparesis and was diagnosed as having moyamoya disease. Case presentation A 23-month-old full-term Moroccan baby boy born to a non-consanguineous couple was referred to our hospital with the complaint of sudden onset left-sided hemiparesis. On neurological examination, there were no signs of meningeal irritation, his gait was hemiplegic, tone was decreased over left side, power was 2/5 over left upper and lower limb, and deep tendon reflexes were exaggerated. Preliminary neuroimaging suggested an arterial ischemic process. Clinical and laboratory evaluation excluded hematologic, metabolic, and vasculitic causes. Cerebral angiography confirmed the diagnosis of moyamoya disease. Our patient was treated with acetylsalicylic acid 5 mg/kg per day and referred to follow-up with pediatric neurosurgeon. Cerebral revascularization surgery using encephaloduroarteriosynangiosis was performed. At 8-month follow-up, his hemiparesis had improved and no further ischemic events had occurred. Conclusion This case highlights the importance of considering moyamoya disease to be one of the classic etiologies of acute ischemic strokes in children from North Africa. It also emphasizes the rare presentation among the African population and the use of neurovascular imaging techniques to facilitate diagnosis of moyamoya disease

Can we use the ankle non-invasive blood pressure during otolaryngologic surgery: an observational study

Introduction: in otolaryngologic surgery, ankle is frequently used for monitoring anesthesia in place of brachial when the patient doesn´t need invasive arterial cannulation. If there is a clinically useful and Predictable link between the two readings in hemodynamic normal patient, this difference during otolaryngologic surgery, was not evaluated. We aimed to investigate the reliability and the acceptability of non invasive blood pressure measurements at the ankle compared to those obtained concurrently at the arm during otolaryngologic surgery. Methods: eighty ASA grade I and II patients who had to be operated under general anesthesia were taken as subjects for our study. Blood pressures were measured simultaneously in the 2 limbs before induction and then every 10 minutes until the end of the surgical procedure. Readings were initiated concurrently. Statistical analysis was performed with PASW Statistics 13. Results: there were 41 males (51.2 %) and 39 females (48.8 %). Bland-Altman analysis of mean difference between the ankle and arm (95 % limits of agreement) was -11.47 (- 23.77 to 0.82)mmHg for systolic blood pressure (SBP), -7.89 (-19.16 to 3.36)mmHg for diastolic blood pressure (DBP) and - 9.09 (18.19 to 0.00)mmHg for mean arterial pressure (MAP). Non-parametric analysis showed that 67.5 % of SBP, 46.2 % of DBP and 56.2 % of MAP measurements differed by > 10mmHg. Conclusion: ankle BP cannot be used routinely in otolaryngological surgery. Although, the ankle can be used as an alternative where the arm cannot be used taking into account a difference

Embarrure suite à l’utilisation de la têtière de Mayfield chez l’adulte: à propos d’un cas et revue de la littérature

Un grand nombre d'interventions neurochirurgicales nécessitent l'utilisation d'une têtière à broches pour immobiliser la tête du patient. Nous rapportons le cas d'une embarrure chez un adulte secondaire à l'utilisation de la têtière de Mayfeild. Le diagnostic a été posé en postopératoire d'une résection chirurgicale d'un médulloblastome par une tomodensitométrie cérébrale. Plusieurs facteurs semblent contribuer à augmenter le risque de complications dues à l'utilisation de la têtière de Mayfield. Les mesures de prévention sont discutées à travers une revue de littérature.The Pan African Medical Journal 2016;2