guide pratique "chirurgie vasculaire "

Emergency Vascular Surgery: A Practical Guide





E. Wahlberg, P. Olofsson, & J. Goldstone, " Emergency Vascular Surgery: A Practical Guide "Springer ISBN: 3540443932 1st edition (July, 2007) 200 pages PDF 9.5 MB MB
“ "Emergency Vascular Surgery" provides detailed guidelines to any physician treating patients with emergency vascular disorders, such as ruptured abdominal aortic aneurysms, acute limb ischemia, vascular trauma, iatrogenic vascular injuries and complications to vascular surgery. It provides an introduction to vascular surgical operations and focuses on how to manage patients from the emergency ward, through the urgent operation and all the way to the immediate postoperative period. Numerous figures illustrate the particular points in vascular techniques and diagnostic problems in the emergency situation.

download link:telecharger ici:

http://rapidshare.com/files/94573101/chirurgie_vascular.rar

dite un petit merci si vous etes satisfait

Deep Cervical Plexus Block "article"

Deep Cervical Plexus Block


Overview

* Indications: Carotid endarterectomy, neck surgery
* Landmarks:
o Mastoid process
o Sternocleidomastoid muscle; posterior border of the clavicular head
o Transverse process of C6
* Equipment: 1½" 22-gauge short bevel needle
* Local Anesthetic: 15-20 mL
* Complexity level: Intermediate

General considerations


A deep cervical plexus block is essentially a paravertebral block of the
C2, C3, and C4 spinal nerves as they emerge from the foramina of
the respective vertebrae. Blockade of the deep cervical plexus
also results in the blockade of the superficial cervical plexus.
A deep cervical block is often accidentally accomplished when
a larger volume of local anesthetic is used in the interscalene brachial plexus block.
The most common clinical use for this block in our practice includes a carotid

0 endarterectomy and removal of cervical lymph nodes.


Regional anesthesia anatomy


The cervical plexus is formed by the anterior divisions of the four upper cervical nerves
. The plexus is situated on the anterior surface of the four upper cervical vertebrae,
resting on the levator anguli scapulae and scalenus medius muscle, and is covered by
the sternocleidomastoid muscle. Their dorsal and ventral roots combine to form spinal
nerves as they exit through the intervertebral foramen. The anterior rami of C2 through C4 form the cervical plexus (the C1 root is a primarily motor nerve and it is not blocked by this technique). The cervical plexus lies in the plane just behind the sternocleidomastoid muscle, giving off both superficial (superficial cervical plexus) and deep branches (deep cervical plexus). The branches of the superficial cervical plexus supply innervation to the skin and superficial structures of the head, neck, and shoulder. The deep branches of the cervical plexus innervate the deeper structures of the neck, including the muscles of the anterior neck and the diaphragm (phrenic nerve). The third and fourth cervical nerves typically send a branch to the spinal accessory nerve, or directly into the deep surface of the trapezius to supply sensory fibers to this muscle.

The fourth cervical nerve may send a branch downward to join the fifth cervical nerve and
participate in the formation of the brachial plexus.


Distribution of anesthesia




The cutaneous innervation of both the deep and superficial cervical plexus blocks includes
skin of the anterolateral neck and the ante- and retro-auricular areas.

Patient positioning

The patient is in the supine or semi-sitting position with the head facing away from the
side to be blocked.



Equipment

A standard regional anesthesia tray is prepared with the following equipment:

* Sterile towels and 4"x4" gauze packs
* 20-mL syringe(s) with local anesthetic
* Sterile gloves and marking pen
* 1½" 25-gauge needle for skin infiltration
* 1½ cm-long, 22-gauge, short bevel needle


Landmarks
Surface Landmarks


The following surface anatomy landmarks are helpful for estimating the location of
the transverse processes: mastoid process, transverse process of the sixth cervical
vertebra (C6), and the posterior border of the sternocleidomastoid muscle.

TIP: The proportions of the shoulder girdle, size of the neck, prominence of the muscles, and other areas vary among patients. For that reason, always perform a "reality check" when in doubt and estimate the three bony landmarks: sternal notch, clavicle, and mastoid process.
Anatomic Landmarks


The following three landmarks for a deep cervical plexus block are identified and marked:

1. Mastoid process
2. Chassaignac's tubercle of C6
3. Posterior border of the sternocleidomastoid muscle




The anatomic landmarks for this block can be accentuated by asking the patient to:

* Turn the head slightly away from the side to be blocked
* Lift the head up (tenses the sternocleidomastoid muscles)
* Reach the knee with the hand on the ipsilateral side

To estimate the line of needle insertion that overlies the transverse processes,
the mastoid process (MP) and Chassaignac's tubercle of C6 transverse process
are identified and marked. The transverse process of C6 is usually easily palpated
behind the clavicular head of the sternocleidomastoid muscle at the level just below
the cricoid cartilage.

Next, a line is drawn connecting the mastoid process (MP) to Chassaignac's tubercle of C6 transverse process. The palpating hand is best positioned just behind the posterior border of the sternoclediomastoid muscle.

Once this line is drawn, the insertion sites over the C2, C3, and C4 are labeled as follows: the C2, C3, and C4 are located on the MP-C6 line some 2-cm, 4-cm, and 6-cm caudal from the mastoid process, respectively.
Technique

Local anesthetic skin infiltration


After cleaning the skin with an antiseptic solution, local anesthetic is infiltrated
subcutaneously alongside the line estimating the position of the transverse processes.
The local anesthetic is best infiltrated over the entire length of the line, rather than at the projected insertion sites. This allows reinsertion of the needle slightly caudally or cranially when the transverse process is not contacted without the need to infiltrate the skin at a new insertion site.
Needle insertion



A needle connected via flexible tubing to the syringe with local anesthetic is inserted between the palpating fingers and advanced at an angle perpendicular to the skin plane. The needle should never be oriented cephalad. A slight caudal orientation of the needle is the single best method to prevent the inadvertent insertion of the needle toward the cervical spinal cord. The needle is advanced slowly until the transverse process is contacted. At this point, the needle is withdrawn 1-2 mm, firmly stabilized, and 4 mL of local anesthetic is injected, after a negative aspiration test for blood. The needle is then removed and the entire procedure is repeated at the consecutive levels.

TIPS:

* The transverse process is typically contacted at a depth of 1-2 cm in most patients. This distance can be further shortened by exerting pressure on the skin during needle advancement.
* The needle should never be advanced beyond 2.5 cm to avoid the risk of cervical cord injury or carotid or vertebral artery puncture.
* Paresthesia is often elicited in proximity to the transverse process but it should not be relied on because of its non-specific radiating pattern.

Goal

* Contact with the posterior tubercle of the transverse process.
* The spinal nerves at the individual levels are located just in front of the transverse process.

TIP: While some books recommend eliciting paresthesia, the nature of the paresthesia is non-specific and often difficult to discern from the local pain during needle advancement.
Image
Failure to contact the transverse process on the first needle pass

When insertion of the needle does not result in contact with the transverse process
within 2 cm, the following maneuvers are followed:

1. Keep the palpating hand in the same position and the skin between the fingers
stretched while avoiding skin movement.
2. Withdraw the needle to the skin, redirect it 15o inferiorly, and repeat
the procedure.
3. Withdraw the needle to the skin, reinsert the needle 1cm caudal, and repeat
the above procedure.

TIPS:

* When these maneuvers fail to result in contact with the transverse process,
the needle should be withdrawn and the landmarks should be reassessed.
* Redirecting the needle cephalad in an attempt to contact the transverse process
should be avoided because it carries a risk of cervical cord injury when the needle
is advanced too deep.

Choice of local anesthetic

A deep cervical plexus block requires 3-5 mL of local anesthetic per level to ensure
reliable blockade. Except perhaps with patients with significant respiratory disease
(blockade of the phrenic nerve), most patients benefit from the use of a long-acting
local anesthetic.
Onset
(min) Anesthesia (hrs) Analgesia (hrs)
1.5% Mepivacaine (+HCO3; + epinephrene) 10-15 2-2.5 3-6
2% Lidocaine (+HCO3; + epinephrene) 10-15 2-3 3-6
0.5% Ropivacaine 10-20 3-4 4-10
0.25% Bupivacaine (+ epinephrene) 10-20 3-4 4-10

Although the placement of deep cervical block may be associated with moderate patient discomfort, excessive sedation should be avoided. During neck surgery the airway management may be difficult due to the shared access to the head and neck with the surgeon. Surgeries like carotid endarterectomy require that the patient be fully conscious, oriented and cooperative during the entire surgical procedure. In addition, excessive sedation and the consequent lack of patient cooperation can result in restlessness and create a difficulty for the surgeon. The onset time for this block is 10-15 minutes. The first sign of the blockade is the decreased sensation in the area of the distribution of the respective components of the cervical plexus. It should be noted that due to the complex arrangement of the neuronal coverage of the various layers in the neck area as well as the cross-coverage from the contralateral side, the anesthesia achieved with cervical plexus block is rarely complete. While this should not be discouraging from the use of cervical plexus block, its use does require an understanding surgeon who is willing to supplement the block with the local anesthetic as necessary.

TIP: Carotid surgery also requires blockade of the glossopharyngeal nerve branches.
This is easily accomplished intraoperatively by injecting the local anesthetic inside the carotid artery sheath.
Complications and How to Avoid Them

Infection
- Low risk
- A strict aseptic technique is used
Hematoma - Avoid multiple needle insertions, particularly in anticoagulated patients
- Keep a 5 minute steady pressure on the site when the carotid artery is inadvertenly
punctured
Phrenic Nerve Blockade - Phrenic nerve blockade (diaphragmatic paresis) invariably
occurs with a deep cervical plexus block
- A deep cervical plexus block should be carefully considered in patients with significant respiratory disease
- Bilateral deep cervical block in such patients may be considered contraindicated
- Blockade of the phrenic nerve does not occur after superficial cervical plexus block
Local anesthetic toxicity - Central nervous system toxicity is the most serious
consequence of the cervical plexus block. This complication occurs because of the rich
vascularity of the neck, including vertebral and carotid artery vessels;
it is usually caused by an inadvertent intravscular injection of local anesthetic rather
then absorbtion
- Careful and frequent aspiration should be performed during the injection
Nerve injury - Local anesthetic should never be injected against resistance or
when the patient complains of severe pain on injection
Spinal anesthesia - This complication may occur with injection of a larger volume of
local anesthetic inside the dural sleeve that accompanies the nerves of the cervical
plexus
- It should be noted that a negative aspiration test for CSF does not rule out the
possibility of intrathecal spread of local anesthetic
- Avoidance of high volume and pressure during injection are the best measures to
avoid this complication

Complications of Regional Anesthesia

Book DescriptionCompletely updated and expanded, this new edition of "Regional Anesthesia: Managing Complications", 2nd edition is essential reading for advice on the prevention and management of complications associated with regional anesthesia and nerve blocks. In addition to comprehensive coverage of all potential pitfalls a practitioner may encounter, new material has been added comparing outcomes of regional and general anesthesia; regional anesthesia in the anesthetized patient; closed claims analyses; and practice guidelines to ensure patient safety.
Book InfoUniv. of Alberta, Edmonton, Canada. Addresses the complications and adverse reactions associated with regional anesthesia. Covers nerve blocks, regional vs. general anesthesia, how to evaluate neurologic injuries, guidelines for reducing risks, case studies, and medical-legal considerations. For practitioners and residents. Softcover. DNLM: Anesthesia, Conduction--adverse effects. --This text refers to the Paperback edition.
Product Details* Paperback: 506 pages* Publisher: Springer; 2nd ed. edition (April 2, 2007)* Language: English* ISBN-10: 0387375597*

ISBN-13: 978-0387375595*

Format: PDF*

Size: 7.41 MB

download links: telecharger apuiyer sur le lien ci dessus:

http://rapidshare.com/files/93715458/Complications_of_Reg_Anesthesia.2007.rar

Atlas of Regional Anesthesia

Atlas of Regional AnesthesiaPages:480The fully updated and revised 3rd edition of this one-of-a-kind, full-color atlas helps you perform nerve blocks accurately and successfully in all regions of the body. Step-by-step illustrations demonstrate each technique in a simple, easy-to-follow manner. An emphasis on cross-sectional anatomy, illustrations of gross and surface anatomy, and CT and MRI scans help you develop a three-dimensional concept of anatomy essential to successful regional anesthesia administration.

download links: telechargement file ci dessus:
http://rapidshare.com/files/39071617/Atlas_of_Regional_Anesthesia.part2.rar
http://rapidshare.com/files/39060356/Atlas_of_Regional_Anesthesia.part1.rar

mirror downloads:
http://www.megaupload.com/?d=2VMVJ378
http://www.megaupload.com/?d=369WHLUY

einstein says :theres two infinities the universe and the humain stupydities .....

traité d'anesthesie generale "dalens"

Traité d’anesthésie générale
A mises à jour périodiquesBernard DALENS

SOMMAIRE

© Groupe Liaisons SA, décembre 2003.

.(Les chapitres en gras ont été publiés. Ceux en maigre apparaîtrontdans la mise à jour de 2004)Avant-proposPrésentation de l’ouvragePartie

I - PhysiologieChapitre

1 Électrophysiologie cardiaque et effets des agents anesthésiques.Antoine GM Aya, Jean-Emmanuel de La CoussayeChapitre

2 Régulation de l’hémodynamique et effet des agents anesthésiquesChapitre

3 Physiologie respiratoire en anesthésie. Laure Martin, Claude EcoffeyChapitre

4 Physiologie rénale. Implications anesthésiques. Frédéric Ethuin, Laurent JacobChapitre

5 Physiologie du système nerveux central : quelques concepts pour l’anesthésie. David Bracco,Bruno BissonnetteChapitre

6 Physiologie de la transmission neuromusculaire. Claude Meistelman, François DonatiChapitre 7 Physiologie du système nerveux autonome. Isabelle ConstantChapitre

8 Physiologie de l’hémostase, des cellules sanguines et hématopoïèse.Marie-Hélène Denninger, Michèle Amar, Marie-Françoise Hurtaud-Roux, Odile FenneteauChapitre

9 Réactions endocriniennes, immunitaires et métaboliques à la chirurgie.Philippe Scherpereel, Benoît Tavernier, Cécile ChambrierChapitre

10 Physiologie hépatique et digestive. Implications en anesthésie-réanimation. Mike Blay,Olivier Pérus, Marc Raucoules-AiméChapitre

11 Physiologie, physiopathologie et évaluation de la douleur. Alain SerrieChapitre

12 Régulation de la température et hypothermie péri-anesthésique.David Bracco, Bruno BissonnetteChapitre

13 Transport de l’oxygène par le sang - Notions de transport du CO2 et des ions hydrogène.Philippe Baele, Philippe van der LindenChapitre

14 Particularités de l’enfant. Aspects anatomiques, physiologiques, psychologiqueset pharmacologiques. Elisabeth GiaufréChapitre

15 Modifications physiologiques au cours de la grossesse et implications anesthésiques.Philippe DaillandChapitre

16 Physiologie du vieillissement. Frédérique ServinChapitre

17 Physiologie et physiopathologie de l’équilibre acidobasique : implications périopératoires.Carole Ichai, Carine Giunti, Jacques Levraut, Dominique GrimaudChapitre 18 Mémorisations périopératoires. Laure Pain, Jean MantzSommaire 14Traité d’anesthésie générale© Groupe Liaisons SA, décembre 2003. La photocopie non autorisée est un délit.Partie II - PharmacologieChapitre

1 Modes d’action des anesthésiques généraux et théories de l’anesthésie générale. MantzChapitre

2 Principes généraux de pharmacocinétique appliqués à l’anesthésie. Luc J. Van ObberghChapitre

3 Principes généraux du métabolisme des anesthésiques. Corinne LejusChapitre 4 Anesthésiques halogénés. Pierre FeissChapitre 5 Hypnotiques intraveineux. Pascal Adnet †Chapitre

6 Curares : pharmacologie, principes de sélection et schémas d’utilisation. Benoît Plaud,François Donati, Claude MeistelmanChapitre

7 Analgésiques. Marcel ChauvinChapitre

8 Pharmacologie des anesthésiques locaux. Lionel Simon, Jean-Xavier MazoitChapitre

9 Pharmacologie des antalgiques mineurs. Frédéric AubrunChapitre

10 Antagonistes en anesthésie-réanimation : pharmacologie et schémas pratiques d’utilisation.Bertrand DebaeneChapitre .

11 Agents de prémédication, sédatifs et vagolytiques. Jean-Pierre HabererChapitre

12 Cristalloïdes et colloïdes. Bernard Allaouchiche, Frédéric Duflo, Dominique ChassardChapitre 13 Pharmacologie et principes d’utilisation des catécholamines. Thomas Geeraerts,Jacques DuranteauChapitre

14 Anticoagulants et antiagrégeants plaquettaires

III - Équipement, matériel et règles de sécuritéChapitre

1 Matériel d’assistance respiratoire et ventilateurs d’anesthésie pour l’adulte. Pierre FeissChapitre

2 Matériel pour le conditionnement du patient. Arnaud Gouchet, Olivier Doucet, Xavier Sauvagnac,Colette MercierChapitre

3 Monitorage peropératoire : matériel, indications et techniques. Jean-Étienne Bazin,Isabelle LangladeChapitre

4 Mesure du débit aortique par méthode non invasive. Raoul MuchadaChapitre

5 Positionnement du patient au bloc opératoire. Serge Molliex, Jean PascalChapitre

6 Organisation du travail anesthésique au bloc opératoire. Jean-Étienne BazinChapitre

7 Matériel et équipement pour l’anesthésie pédiatrique. Francis VeyckemansChapitre

8 Prévention des infections nosocomiales et du risque infectieux pour le personnel.Évelyne Raybaud, Chantal Pobeau, Ousmane Traore, Henri LaveranChapitre

9 Dossier médical et feuille d’anesthésie. Laurent Beydon, Laurent Dubé, Laurence VachonChapitre

10 Exposition professionnelle aux gaz et vapeurs anesthésiques. Christine BretonChapitre

11 Réseau d’alimentation et sécurité électrique au bloc opératoire.Alexandre Toesca, Daniel Blanc, Laurent MohedanoChapitre

12 Interférences électromagnétiques au bloc opératoire et leur prévention. Jean-Jacques BoigePartie

IV - Prise en charge et stratégies anesthésiques courantes

1 Consultation d’anesthésie : examens complémentaires préopératoires. Informationet préparation du patient. François Gouin, Catherine Guidon, Marc Bonnet, Philippe GrilloChapitre 2 Prémédication (avec règles du jeûne opératoire) et techniques de sédation(en particulier Monitored Patient-Controlled Sedation – MPCS)Chapitre

3 Oxygénation préalable à l’anesthésie générale (préoxygénation). Jacques FusciardiChapitre

4 Induction et entretien de l’anesthésie. Xavier Viviand, Serge MolliexChapitre

5 Techniques de blocs périphériques des membres chez l’adulte. Jean-Jacques Eledjam,Jacques Ripart, Bruno Bassoul, Éric VielChapitre

6 Techniques de blocs centraux chez l’adulte. Frédéric Adam, Francis Bonnet15Sommaire Traité d’anesthésie générale© Groupe Liaisons SA, décembre 2003. La photocopie non autorisée est un délit.Chapitre

7 Anesthésie locorégionale intraveineuse et anesthésie locale par infiltration. Louis-Jean DupréChapitre

8 Anesthésies générale et locorégionale combinée en chirurgie réglée chez l’adulte.Philippe Aknin, Philippe Kirstetter, Philippe MacaireChapitre

9 Anesthésie en ventilation spontanée. David Popesco, Philippe Montravers, Amar Ben AmmarChapitre

10 Apports, remplissage et compensation des pertes peropératoires. Nathalie Bernard,Sandrine Lopez, Yves Ryckwaert, Xavier CapdevilaChapitre

11 Introduction à la chirurgie ambulatoire. Guy BazinChapitre

12 Anesthésie en dehors du bloc opératoire. Jean-Étienne Bazin, Myriam Verny-PicChapitre

13 Stratégie préopératoire d’épargne sanguine homologue chez l’adulte. Nadia Rosencher,Luc Eyrolle, Yves Ozier, Anissa Belbachir, Christian ConseillerChapitre

14 Stratégie périopératoire d’épargne sanguine homologue chez l’enfant. Marie-Noëlle MayerChapitre

15 Réveil postopératoire. Anne-Marie Cros, François Semjen, François SztarkChapitre

16 Antibiothérapie et antibioprophylaxie en anesthésie. Benoît Veber, Gaëlle Demeilliers-Psister,Isabelle Aimé, Olivier CollangeChapitre

17 Techniques et stratégies de prise en charge de la douleur postopératoire. Marcel ChauvinChapitre

18 Place des antalgiques mineurs dans la prise en charge de la douleur postopératoire.Frédéric AubrunChapitre

19 Hypotension contrôlée et hypothermie intentionnelle. François Kerbaul, Nicolas BruderPartie V - Gestion des situations critiques et des complications

1 Anesthésie du patient polytraumatisé. Pierre Carli, Caroline TélionChapitre

2 Troubles thermiques peropératoires. Renée Krivosic-Horber, Thierry Dépret, Pascal Adnet †Chapitre

3 Arrêt cardiocirculatoire – adulte et enfant. Caroline Télion, Pierre CarliChapitre

4 Complications hémodynamiques périopératoires et leur gestion. Benoît Vivien, Pierre CoriatChapitre

5 Troubles du rythme cardiaque peropératoires et leur traitement. Antoine GM Aya, Jean-PierreBertinchant, Jérôme Brunet, Jean-Emmanuel de La CoussayeChapitre

6 Complications respiratoires au cours de l’anesthésie. Bertrand Dureuil, Romain Gillet,Gaëlle Demeilliers-PfisterChapitre

7 Insuffisance et dysfonctionnements rénaux périopératoires. Marie-Laure Cittanova,Ouardia ZerhouniChapitre

8 Prise en charge anesthésique des urgences obstétricales. Philippe DaillandChapitre

9 Anesthésie de la femme enceinte pour une chirurgie non obstétricale. Philippe DaillandChapitre

10 Complications survenant à l’induction. Maryline Bordes, Anne-Marie Cros, François SztarkChapitre

11 Complications postopératoires précoces et leur prévention. François Gouin, Catherine Guidon,Marc Bonnet, Philippe GrilloChapitre

12 Embolie gazeuse au bloc opératoire. Marc Fischler, Jean-Dominique Law-KounePartie

VI - Techniques et monitoring particuliers

1 Techniques d’assistance ventilatoire. Sophie Petit, Abderrahim Maatoug, Denis Hausberger,Pierre Diemunsch, Jocelyne Valfrey, Thierry PottecherChapitre

2 Techniques d’abord vasculaire et d’assistance hémodynamique. Martine Ferrandière,Marc Laffon, Xavier Sauvagnac, Dominique Garnaud, Colette MercierChapitre

3 Contrôle pharyngé des voies aériennes et ventilation contrôlée. Anne-Marie Cros,Fabrice Chopin, Anne DidierChapitre

4 Monitorage de la pression intracrânienne. Lamine Abdennour, Thomas Lescot, Louis PuybassetChapitre

5 Hypnose et anesthésie : aspects neurophysiologiques et implications pratiques.Marie-Élisabeth Faymonville, Steve Laureys, Jean Joris, Maurice Lamy, Pierre MaquetSommaire 16Traité d’anesthésie générale© Groupe Liaisons SA, décembre 2003. La photocopie non autorisée est un délit.

6 Contrôle de l’intégrité fonctionnelle de la moelle épinière. Olivier LangeronChapitre

7 Surveillance de la profondeur de l’anesthésie. Valérie BillardPartie VII - Spécificités anesthésiques selon le terrainChapitre 1 Anesthésie du sujet âgé. Frédérique Servin, Philippe JuvinChapitre

2 Anesthésie générale de l’enfant. Francis VeyckemansChapitre

3 Anesthésie locorégionale chez l’enfant. Bernard DalensChapitre

4 Anesthésie de la femme enceinte : en dehors du travail, pour le travail et pour la césarienne.Gilles Boulay, Lionel Simon, Laure de Saint Blanquat, Jamil HamzaChapitre

5 Analgésie locorégionale pour le travail obstétrical. Dan Benhamou, Frédéric MercierChapitre

6 Anesthésie d’un patient souffrant d’insuffisance hépatocellulaire et/ou d’hypertensionportale. Guy Armando, Olivier Perus, Marc Raucoules-AiméChapitre

7 Prise en charge périopératoire d’un patient porteur d’un trouble de l’hémostase, ou traitépar anticoagulants ou antiagrégeants plaquettaires. Charles Marc Samama, Emmanuel Marret,Marianne Scholtès, Sandrine Pham-Tourreau, Joanne Guay, Philippe de MoerlooseChapitre

8 Interactions entre médicaments cardiovasculaires et anesthésie. Luc Brun, Gilles Boccara,Pierre CoriatChapitre

9 Anesthésie d’un patient transplanté pour une chirurgie autre que la transplantation.Annick Steib, Danielle Le MahoChapitre

10 Anesthésie du patient en état de choc. Dominique Santelli, Denis Ortéga, Claude MartinChapitre

11 Anesthésie du patient cardiaque. Vincent Piriou, Abdellah Aouifi, Jean-Jacques LehotChapitre

12 Anesthésie d’un patient souffrant de pathologie respiratoire sévère. Bertrand DureuilChapitre 13 Asthme et pathologies allergiques graves : conduite de l’anesthésie. Dominique Chassard,Bernard Allaouchiche, Jean-Pierre Tournadre †Chapitre

14 Anesthésie d’un patient souffrant d’une affection neuromusculaire. Benoît Plaud,Claude MeistelmanChapitre

15 Anesthésie d’un patient atteint d’insuffisance rénale. Marie-Laure CittanovaChapitre

16 Anesthésie de l’obèse et pour chirurgie de l’obésitéChapitre

17 Anesthésie et endocrinopathies. Annick Steib, Philippe Plobner, Valérie Balabaud-Pichon,Claire Esclope-Winter, Daniel JaeckPartie

VIII - Spécificités anesthésiques selon les spécialités chirurgicales

1 Anesthésie pour chirurgie digestive générale, occlusion intestinale et péritoniteChapitre

2 Anesthésie en orthopédie. Paul Joseph ZetlaouiChapitre

3 Anesthésie pour chirurgie urologique. Jean-Marc Malinovsky, Géraldine RenaudChapitre

4 Anesthésie pour masse intracrânienne. Patrick Ravussin, Oliver Wilder-SmithChapitre

5 Anesthésie en neurotraumatologie. Gérard Audibert, Claire CharpentierChapitre

6 Anesthésie pour chirurgie cardiaque. Luc Barvais, Anne Ducart, Denis Schmartz, Andrée de VilléChapitre

7 Anesthésie et chirurgie de l’aorte abdominale. Ariane Junca, Francis BonnetChapitre

8 Anesthésie en chirurgie thoracique. Pierre Michelet, Antoine Roch, François Prima, Salem Hamana,Jean-Pierre AuffrayChapitre

9 Anesthésie-réanimation en otorhinolaryngologie. Jean-Louis Bourgain, Elizabeth HentgenChapitre

10 Anesthésie pour chirurgie ophtalmologique. Jacques Ripart, Jean-Jacques EledjamChapitre 11 Anesthésie pour chirurgie et maladies du foie. Yves Ozier, Claude LentschenerChapitre

12 Anesthésie pour chirurgie de l’œsophageChapitre

13 Prise en charge anesthésique et analgésique des brûlés. Jacky Laguerre, Pierre MarsolChapitre

14 Anesthésie en odontostomatologie. Philippe Pendeville, Sergio Siciliano, Alain Mayne,Bénédicte Bayet, Hervé Reychler, Charles PilipiliTraité d’anesthésie générale© Groupe Liaisons SA, décembre 2003. La photocopie non autorisée est un délit.Chapitre

15 Anesthésie pour chirurgie plastique et esthétique. Philippe Richebé, Jean-Christophe Ha,Pierre MauretteChapitre

16 Anesthésie pour transplantation hépatique. Marie-Pierre Dilly, Jean MartyChapitre

17 Anesthésie et réanimation pour transplantation cardiaque et cœur-poumon. Olivier Bastien,Philippe Léger, Philippe Mauriat, Michel VidecoqPartie

IX - Risque, éthique, responsabilité, formation et réglementation

1 Morbidité et mortalité de l’anesthésie. Françoise d’Athis, Philippe BibouletChapitre

2 Droits du patient. Information et consentement. Henri BricardChapitre

3 Cadre légal de l’exercice de l’Anesthésie-Réanimation en France. Guy Le GallChapitre

4 Infirmier anesthésiste. Cadre réglementaire, exercice professionnel, responsabilité.Élisabeth BalagnyChapitre

5 Responsabilité médicale en anesthésie-réanimation. Alain GarayChapitre

6 Évaluation des coûts de la pratique anesthésique. Philippe Gorce, Jean-Louis PourriatChapitre 7 Le risque anesthésique et les démarches d’assurance-qualité. François Clergue,Philippe GarnerinChapitre

8 Analyse et maîtrise du risque en anesthésie. Michel SfezChapitre

9 Organisation des vigilances et gestion des risques dans les structures hospitalières.Gérard Janvier, Pierre Maurette, Pierre FialonChapitre

10 Syndicats professionnels, rôle et perspectives. Marcel-Louis ViallardChapitre

11 Épuisement professionnel : risques pour le patient et le médecin. Implicationsorganisationnelles. Jean Marty, Meriam LamraouiChapitre

12 Gestion d’une complication anesthésique : aspects juridiques, humains et administratifs.Sophie GrombChapitre

13 Utilisation des services en ligne et des moyens d’information électroniquedans la pratique quotidienne de l’anesthésie. Bruno Grenier, Marc DubreuilChapitre

14 Risques de contamination professionnelle en anesthésie.

download link: telecharger url ci dessus:

http://rapidshare.com/files/93696243/anesthesie_generale_cnms.rar

Aortic Dissection and Related Syndromes (Developments in Cardiovascular Medicine)

Aortic Dissection and Related Syndromes (Developments in Cardiovascular Medicine)
Publisher: Springer
Number Of Pages: 416
Publication Date: 2006-12-18
Sales Rank: 1642848
ISBN / ASIN: 038736000X
EAN: 9780387360003
Binding: Hardcover
Manufacturer: Springer
Studio: Springer
Average Rating:
Total Reviews:

Book Description: )

Aortic dissection affects approximately two in ten thousand individuals and can be fatal. This state-of the-art publication is a result of the combined efforts of participants from the International Registry of Aortic Dissection (IRAD). The book has been divided into sections. Each chapter provides a succinct overview of the current clinical literature and incorporates illustrations for further explanation.

5.64 MB RAR'd PDf

download link:

http://rapidshare.com/files/25284262/Bal_AorDisanRelSyn.rar

passrar:pass: giga

Atrial Fibrillation after Cardiac Surgery (DEVELOPMENTS IN CARDIOVASCULAR MEDICINE Volume 222) (Developments in Cardiovascular

Atrial Fibrillation after Cardiac Surgery (DEVELOPMENTS IN CARDIOVASCULAR MEDICINE Volume 222) (Developments in Cardiovascular Medicine)Springer ISBN:0792386558 Edition - 1999-11-01 PDF 184 pages 9.1 MB Rapidshare & MegauploadCardiac surgery is performed on hundreds of thousands of patients a year, and can have an important beneficial impact on the outcomes of patients with coronary and valvular heart diseases. Despite the favorable recovery of most patients, some will have their post-operative period interrupted by the development of atrial fibrillation, with a host of potential complications including stroke. High risk subgroups may develop atrial fibrillation in more than half of cases, and often despite aggressive prophylactic measures. Treatment of atrial fibrillation and its aftermath can also add days to the hospital stay of the cardiac surgical patient. In an era of aggressive cost cutting and optimization of utilization of health care resources, the financial impact of this arrhythmic complication may be enormous.Experimental studies have led to a greater understanding of the mechanism of atrial fibrillation and potential precipitating factors in the cardiac surgical patient. Prophylactic efforts with beta-blockers, antiarrhythmic drugs and atrial pacing are being used, or are being investigated in clinical trials. New methods of achieving prompt cardioversion with minimal disruption of patient care, and prevention of the thromboembolic complications of atrial fibrillation, are also important therapeutic initiatives. This text is designed to aid health care professionals in the treatment of their patients in the recovery period after cardiac surgery, and to instigate additional research efforts to limit the occurrence of, and the complications following, this tenacious postoperative arrhythmia.

http://rapidshare.com/files/80883079/Atrial_Fibrillation_after_Cardiac_Surgery.rar

Advanced Therapy in Cardiac Surgery

Publisher: B.C. DeckerNumber Of Pages: 543Publication Date: 1999-04-15Sales Rank: 3056624ISBN / ASIN: 1550090526EAN: 9781550090529Binding: PaperbackManufacturer: B.C. DeckerStudio: B.C. DeckerAverage Rating:

download links:
http://mihd.net/4jbn0f
mirror1
http://rapidshare.com/files/52440398/Advanced_Therapy_in_Cardiac_Surgery_.1st.ed.1999..djvu

mirror2:

http://rapidshare.com/files/52272802/544345.rar.html


passrar: http://z15.invisionfree.com/lekar/

Perioperative Critical Care Cardiology (Topics in Anaesthesia and Critical Care)

Publisher: SpringerNumber Of Pages: 282Publication Date: 2007-01Sales Rank: 3886802ISBN / ASIN: 8847005574EAN: 9788847005570Binding: PaperbackManufacturer: SpringerStudio: Springer
In this book are discussed topics of particular importance to critical care cardiovascular diagnosis and management in the perioperative period. Chapter topics are the causes for heart failure; the pathophysiology of heart failure; coronary heart disease and ischemic preconditioning; hypertensive urgencies and emergencies; diagnosis of heart failure; preoperative cardiac risk assessment; hemodynamic monitoring in patients with heart failure; electrocardiography of heart failure - features and arrhythmias; pharmacologic management for patients with heart failure; devices for management of heart failure; pacemaker and internal cardioverter-defibrillator therapies; management of cardiopulmonary arrest; circulatory shock - anaphylactic, cardiogenic, haemorrhagic, septic; prevention and management of cardiac dysfunction during and after cardiac surgery; vasodilator therapy - systemic and pulmonary; and, thromboembolism and anticoagulation. This work represents an important update for anaesthesiologists, cardiologists, cardiac surgeons, emergency care physicians and intensivists caring for patients with acute, life-threatening cardiovascular afflictions.

download links:

http://rapidshare.com/files/52389436/Perioperative.rar
http://www.zshare.net/download/345265002d8f3b/

Perioperative Care in CArdiac Anesthesia and Surgery Landes

this the master book that help you to know and learn more about live care in cardiac anesthesia
how to prepare our patient for all alternative intervention and the keys of methodes in anesthesia it's the use full book

DOWNLOAD LINKS:
http://rapidshare.com/files/84436692/Perioperative_Care_in_Cardiac_Anesthesia_and_Surgery-Landes_Bioscience-1999.pdf

Coronary Sinus Interventions in Cardiac Surgery, 2nd Ed.

Coronary Sinus Interventions in Cardiac Surgery, 2nd Ed.Publisher:Eurekah.Com 2000-08-30 ISBN:158706006X Pages:224 PDF 3 MBCoronary Sinus Interventions in Cardiac Surgery, 2nd Ed. (Medical Intelligence Unit)By dr_jivago

DOWNLOAD LINKS:

http://rapidshare.com/files/67541671/Coronary_Sinus_Interventions.rar

mirror download :

http://www.filefactory.com/file/9ce0c2/

SIX MINUTES to learn ECG_ the easyst way

hi the file contens the most and the best methode interactive with illustration to learn all the arythmiques troubles and to test also your knowledgs

http://rapidshare.com/files/93419870/the_six_second_to_learn_ecg.rar

passrar:cnms_hospital

anesthesia in cardiac surgery kaplan 5ve edition revised

y Joel A. Kaplan, David L. Reich, Carol L. Lake, Steven N. Konstadt,

Publisher: Saunders Number Of Pages: 1424 Publication Date: 2006-03-17 Sales Rank: 219302 ISBN / ASIN: 1416002537 EAN: 9781416002536 Binding: Hardcover Manufacturer: Saunders Studio: Saunders Average Rating: Total Reviews:

Book Description: )
Dr. Kaplan and a multitude of other eminent specialists have completely updated and revised the 5th Edition of this definitive bible of cardiac anesthesia. They present detailed information on all the latest techniques, and offer the essential guidance readers need when administering anesthesia to cardiac surgery patients as well as cardiac patients undergoing non-cardiac surgery. Inside, readers will find 12 new chapters plus all other chapters extensively updated, three renowned new associate editorsDr. David L. Reich, Dr. Carol L. Lake, and Dr. Steven N. Konstadtand detailed discussions of the hottest topics.
http://rapidshare.com/files/24408444/Kaplan_Cardiac_Anesthesia.rar.html
http://rapidshare.com/files/24422661/CARDIAC_ANESTHESIA.rar.html