Simulation : Le coeur numérique par Hervé Delingette et Miguel Fernandez. De l'ordinateur à la clinique, entretien avec Jérôme Garot, propos recueillis par Dominique Chouchan. Améliorer les performances des implants cardiaques par Alain Ripart

National audienceUn modèle numérique du coeur et des fonctions cardiaques, c'est presque pour demain. Médecins et informaticiens s'associent pour s'attaquer aux maladies cardiovasculaires, la première cause de mortalité dans le monde

Ophtalmic regional anesthesia: medial canthus episcleral (Sub-Tenon) anesthesia is more efficient than peribulbar anesthesia

Background: Regional anesthesia and especially peribulbar anesthesia commonly is used for cataract surgery. Failure rates and need for reinjection remains high, however, with peribulbar anesthesia. Single-injection high-volume medial canthus episcleral (sub-Tenon's) anesthesia has proven to be an efficient and safe alternative to peribulbar anesthesia. Methods: The authors, in a blind study, compared the effectiveness of both techniques in 66 patients randomly assigned to episcleral anesthesia or single-injection peribulbar anesthesia. Motor blockade (akinesia) was used as the main index of anesthesia effectiveness. It was assessed using an 18-point scale (0 -3 for each of the four directions of the gaze, lid opening, and lid closing, the total being from 0 ‫؍‬ normal mobility to 18 ‫؍‬ no movement at all). This score was compared between the groups 1, 5, 10, and 15 min after injection and at the end of the surgical procedures. Time to onset of the blockade also was compared between the two groups, as was the incidence of incomplete blockade with a need for supplemental injection and the satisfaction of the surgeon, patient, and anesthesiologist