General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients’ (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16–22) and failed intubation in 1 in 312 (95%CI 1 in 169–667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

L’allergie alimentaire a l’oeuf chez l’enfant Togolais en consultation de pneumo-allergologie au Chu-campus de Lome: Frequence, manifestations cliniques

Introduction : Le but de notre étude était d’analyser les aspects épidémiologiques et cliniques de l’allergie à l’oeuf chez l’enfant au Togo.Méthodologie : Il s’est agi d’une étude rétrospective portant sur 95 enfants âgés de 6 mois à 15 ans ayant consulté dans le service de pédiatrie du CHU-Campus de Lomé entre 2000 et 2009 pour des symptômes persistants évoquant une allergie. Nous avons inclus dans notre étude les enfants âgés de 6 mois à 15 ans ayant des tests cutanés positifs à l’oeuf.Résultats : La fréquence de l’allergie à l’oeuf était de 11,65%. La tranche d’âge la plus touchée était celle de 30 mois à 6 ans (42,1%). Chez 63,07% des patients, les symptômes ont débuté entre 6 et 30 mois. Lesmotifs de consultation étaient l’éternuement (43,15%) et la toux (42,1%).Conclusion : L’allergie à l’oeuf est fréquente chez l’enfant togolais. Elle touche plus les garçons.Mots clés : Allergie, oeuf, enfant, Togo, Egg allergy in togolese children at pneumo-allergology consultation at the Campus teaching hospital of Lome. Frequency and clinical manifestations. Introduction: This sturdy aims at determine the frequency and analyze the clinical manifestation of egg allergy in Togolese children at the Campus teaching hospital of Lome.Methodology: It is a retrospective sturdy concerning 95 children (aged from 6 mouth to 15 years) examined at the campus teaching hospital of Lome, pediatric section, between 2000 and 2009 for allergy symptoms. We included in our sturdy student aged from 6 mouth to 15 years with positive egg skin test.Results: The frequency of egg allergy in our sturdy is 11.65%. Children aged between 6 month and 6 years were more affected (42.17%). We notice that 63. 07% of our patient began their symptom between6 and 30 mouth. The reasons of consultation were sneezing (43.15%) and cough (42.1%).Conclusion: Egg allergy is frequent in Togo and male are more affected.Keys words: Allergy, Egg, children, Togo