[Antibiotic prophylaxis à la carte in self-contaminated gynecologic and obstetric surgery: importance of cefotaxime]. / Antibioprophylaxie à la carte en chirurgie gynécologique et obstétricale propre contaminée: intérêt du céfotaxime.

Infections represents 5% of our post-operative morbidity and result in the use of expensive antibiotics and longer hospital stays. As a less expensive alternative to systematic antibiotherapy for all patients, the authors propose a prospective and descriptive study of the effectiveness of antibioprophylaxis by administering 1 g of Cefotaxime pre-operatively. The study concerns a continuous series of 103 cases in gynaecology and obstetrics operated in the Dakar University Teaching Hospital, during a 13 months period (April 95-April 96). The average age of the patients is 30 years, the major types of surgery was cesarean sections, laparotomy for extra-uterine pregnancy and myomectomies. The duration of the surgery varied between 40 to 105 minutes with an average of 60 minutes. There was no intolerance to Cefotaxime. No cases of post operative infections were observed. All surgical wounds healed in 6 to 8 days except 2 minor cases of non-union of 1 cm. Antibioprophylaxis with Cefotaxime can therefore be considered as an effective means of preventing post-operative infections in clean surgery. It is easy to administer and also has the advantage of lower cost (4050 Fcfa compared to 29,000 Fcfa for classic antibiotherapy).

Cost effective prophylaxys of postoperative nausea and vomiting by anesthetic premedication.

Postoperative emesis is a common daily problem in anesthetic practice. Authors report their experience about prevention of PONV (postoperative nausea and vomiting) with the association of different drugs in premedication, and suggest Promethazine as an effective and inexpensive medication to prevent PONV in orthopedic surgery.

Cost comparison of anesthetic regimens in the dog and cat.

Comparative costs of anesthetic regimens for the dog and cat were calculated. Various combinations of currently popular sedatives, tranquilizers, and anti-muscarinics (preanesthetic drugs), and anesthetic induction and maintenance drugs were studied. The preanesthetic drug affected overall anesthetic cost through its own cost, its effect on the amount of anesthetic drug necessary for intubation, and its effect on the amount of anesthetic necessary to maintain anesthesia. The combination of acetylpromazine-thiamylal-halothane was the least expensive regimen for both the dog and cat, whereas drug combinations that included isoflurane as the maintenance drug were the most expensive. In the cat, induction of anesthesia by use of N2O, O2, and halothane in a plexiglas chamber was more expensive than by the use of thiamylal.