Brachial plexus block and upper limb regional anesthesia

The authors report their experience about 50 cases of supra clavicular plexus block realised by Kulen-Kampff method. The anesthesia obtained has been complete in 84% of cases and in the 16% remaining general anaesthesia was necessery to permit surgery. A case of moderate pleural detachment lately and a case of post anaesthesia paresthesia both spontaneously resolvent were registered. Actualy the adoption of perivascular techniques of brachial plexus anaesthesia [interscalenic, supraclavicular, axillary] have greatly improved the performance of this variety of upper limb locoregional anaesthesia, thus reducing the percentage of failure and eliminating or reducing the risk of pneumo-thorax. Locoregional anaesthesia of the upper limb should constitute a daily method in the surgery of upper limb and not a technic subordinated to the contra-indications of general anaesthesia

injury severity score: a prognosis index in multiple injuries patients. 400 cases report

For the early, objective and quantitative evaluation of prognostic in multiple injuries patients, the authors would like to introduce in their current practice the injury severity score [ISS]. This clinical score is based on the abbreviated injury scale [AIS] witch divide the human body into four parts: head, face, trunk and limbs. Mean ISS equal 35.8 while mortality rate reach 52%. The matter of fact is that mortality is proportional to ISS rise: when the ISS is between 30 and 40, mortality reach 50%; when ISS is lower, prognostic improve, but when it exceed 50, prognosis is awfull. For a best evaluation of prognossis of polytraumatised, the authors propose to group head and face injuries in a same column of cotation and to divide trunkular injuries into chest and abdominal injuries

Intentional normovolemic hemodilution with autotransfusion. Report of 20 cases

Issuing from this work, it is proved that the intentional normovolemic hemodilution is a technique with numerous adventages and containing no risks. Effectively, blood economy and the possibility to compensate the per-operatory bleeding by means of auto-transfusion, make clear that the application of this technique aught to bring about a changer of the transfusional therapeutics policy, and incite doctors to modify their attitude facing any hemorrage surgery. If the intentional normovolemic hemodilution constitutes a certain place in the field of blood transfusion, there is nothing left except the intentional decrease of the hematocrit and the determining increase in the diminution of the globular loss in the course of the per-operatory haemorrhage