Anesthesie au cours des ventriculocisternostomies au Mali : Une serie de 31 cas

Introduction La ventriculocisternostomie est une technique moderne du traitement des hydrocéphalies. Elle est peu fréquente en Afrique. Objectif:  Décrire la prise en charge anesthésique et l’évolution des patients opérés par ventriculocisternostomie. Patients et Méthode: Etude de cohorte prospective de 15 mois de janvier 2014 au 31 mars 2015. La saisie et l’analyse des données ont été effectuées par Microsoft word 2010 Epi info 3.5.3.fr. Résultats:  Les nourrissons prédominaient avec un sexe ratio de 1,81 en faveur du sexe masculin. Un antécédent de méningite ou d’infection respiratoire à répétition a été retrouvé chez 10 patients (32,2%). L’indication de la ventriculocisternostomie était une hydrocéphalie chez 30 patients (96, 8%). La classe ASA était II chez 19 patients (61,3%). L’intubation était prévue difficile chez 28 patients (90,3%).Tous les patients ont été opérés sous anesthésie générale. Une antibioprophylaxie a été faite chez tous les patients. La tachycardie isolée a été le seul évènement indésirable per opératoire observé chez 13 patients (41,9%). La durée de la chirurgie était de 62, 25 ± 20,9 minutes celle de l’anesthésie était de 93,5 ± 25,4 minutes. En postopératoire, une complication a été observée chez 7 patients (22,6%). Il s’agissait d’une méningite chez 3 patients (42,9%), d’une souffrance cérébrale, d’une obstruction de la stomie, d’un abcès cérébral et une paralysie du nerf III dans 14,3% chacune (1 patient). L’évolution était favorable chez 29 patients (93,5%). La durée médiane d’hospitalisation était de 3 jours. Conclusion:  Au Mali, la prise en charge anesthésique au cours de la ventriculocisternostomie s’adresse à une population pédiatrique avec un terrain précaire.   English title: Anesthesia during endoscopic third ventriculostomy in Mali: A series of 31 cases Introduction: Endoscopic Third Ventriculostomy (ETV) is a modern technique for the treatment of hydrocephalus. It is uncommon in Africa. Objective To describe ananesthesic management and the outcome of patients operated on by ETV. Patients and Methods Prospective cohort study over 15 months to January 2014 at 31 march 2015. The data entry and analysis were done by word office, Epi info 3.5.3.fr. Results: Infants predominated with a sex ratio of 1.81 in favor of men. A history of meningitis or recurrent respiratory infection was found in 10 patients (32.2%). The indication of ETV was hydrocephalus in 30 patients (96.8%). The ASA class was II in 19 patients (61.3%).  Intubation was expected to be difficult in 28 patients (90.3%). All patients were operated on under general anesthesia. Antibiotic  prophylaxis was done in all patients. Isolated tachycardia was the only peroperative adverse event observed in 13 patients (41.9%). The duration of the surgery was 62.25 ± 20.9 minutes that of the anesthesia was 93.5 ± 25.4 minutes. Postoperatively, a complication was observed in 7 patients (22.6%). It was meningitis in 3 patients (42.9%), brain pain, obstruction of the stoma, brain abscess and nerve III paralysis in 14.3% each (1 patient). The outcome was favorable in 29 patients (93.5%). The median hospital stay was 3 days. Conclusion:  In Mali, anesthetic management during ETV is aimed at a pediatric population with precarious terrain

Anesthesiology of Emergency Caesarean Section at Gabriel Toure CHU

Introduction: The aim of this study was to evaluate the anesthesiological management of emergency caesareans at the CHU Gabriel TOURE. Methodology: This was a prospective study that took place at the CHU Gabriel TOURE in the Anesthesia Resuscitation department and in the operating theater of the Gyneco-Obstetrics department from August 01 to October 31, 2021. It concerned all caesarean sections performed in the Gyneco-Obstetrics department of the CHU Gabriel TOURE during a period of three months. All patients who came urgently to the Gyneco-Obstetrics department during the study period with an indication for emergency caesarean section Patients operated for emergency caesarean in another center were not included: caesareans performed outside our study period, planned caesareans, ruptured GEU (ectopic pregnancy), haemostasis hysterectomy. The information obtained from the patients and in the prenatal consultation book is compiled on an individual data collection sheet on which the variables to be studied appear. Statistical analysis was performed using SPSS version 25 software. Microsoft Word software was used for word processing. Results: During the study period, we performed 168 emergency cesarean sections out of 389 cases of cesarean section, i.e. a frequency of 43.18%. Conclusion: The practice of emergency obstetric anesthesia poses organizational difficulties, linked to the absence of a post-operative monitoring room, information from the anesthesia team and availability of products. PRH was the most frequent surgical indication; for this reason, GA has been the most practiced technique. Many patients were transferred to intensive care, i.e. 38.69% of cases and we recorded 38.69% of complications.</jats:p

Incidents and Accidents during Anesthesia in Scheduled and Emergency Surgery at the Gabriel Toure Hospital

Introduction: The aim of this study was to evaluate the incidents and accidents during anesthesia in surgery at the Gabriel TOURE hospital. Methodology: This was a descriptive prospective study of anesthetic incidents and accidents that took place in the anesthesia department of the Gabriel TOURE hospital on the operating sites of programs and surgical and gyneco-obstetric emergencies ranging from the 1st January to March 31, 2021. Our study focused on all patients who underwent emergency and scheduled anesthesia during the period. Included were all patients with at least one accident or incident, All patients who did not present accidents and incidents or who refused to participate in the study were not included. The data was collected on the survey sheets and analyzed using the EPI INFO 7 software. Data entry was made using Windows XP software. Results: Over a period of 03 months, we collected 741 patients operated on in the operating theaters of the Gabriel TOURE hospital, of which 100 patients presented accidents/incidents in scheduled and emergency surgery, i.e. a rate of 13.49%. Urgent surgery represents 15.23% of incidents or accidents. Conclusion: We were able to take stock of several elements related to our practice of anesthesia. One of the essential interests of this work was the comparison of a population of subjects having "been victims of an anesthesia accident to the whole population anesthetized in the same structures, by the same practitioners, over the same period of study”.</jats:p