Exploring sexualized substance use, sexual behaviors and HIV-screening practices in people attending erotic industry shows.

Previous studies showed that Erotic industry sShows (ES) were appropriate events for sexual health promotion and testing interventions. A cross-sectional survey exploring screening practices, sexual behaviors, substance use, and sexual motives for substance use was conducted in ES in December 2017 and completed by 781 respondents. Overall, . Eighteen18% percent reported substance use in the last 3 months (51% alcohol), 26%. Twenty-six percent reported a sexual purpose for substance use. Main sexual partners were spouse (68%), regular (21%), unknown (18%) and several (17%) partners. Main sexual practices were libertinism (22%), partner swapping (15%) and threesome (15%). Twenty-seven percent of respondents reported cContactless sex was reported by 27% of the respondents. 18% reported no previous HIV test. Univariate analysis showed that having or not previous HIV test was linked to male sex (76.8% vs. 54.5%, p < 10-3), alcohol consumption in the last three months (58.7% vs. 49.4%, p = .043), number of drugs in a lifetime (1.3% vs. 1.6%, p = .022), sexual partnership with spouse/long-term partner (57.3% vs. 70.5%; p = .002), at least one multiple-partner sexual practice (23.1% vs. 31.8%, p = .040) and type of sexual attraction (p = <10-3). Results contribute to establishing the usefulness of HIV-testing and awareness campaigns in ES eventsand informing potential combined risk behaviors and related interventions.

Comparison of the Glidescope, the McGrath, the Airtraq and the Macintosh laryngoscopes in simulated difficult airways*.

SUMMARY: Several indirect laryngoscopes have recently been developed, but relatively few have been formally compared. In this study we evaluated the efficacy and the usability of the Macintosh, the Glidescope, the McGrath and the Airtraq laryngoscopes. Sixty anaesthesia providers (20 staff, 20 residents, and 20 nurses) were enrolled into this study. The volunteers intubated the trachea of a Laerdal SimMan manikin in three simulated difficult airway scenarios. In all scenarios, indirect laryngoscopes provided better laryngeal exposure than the Macintosh blade and appeared to produce less dental trauma. In the most difficult scenario (tongue oedema), the Macintosh blade was associated with a high rate of failure and prolonged intubation times whereas indirect laryngoscopes improved intubation time and rarely failed. Indirect laryngoscopes were judged easier to use than the Macintosh. Differences existed between indirect devices. The Airtraq consistently provided the most rapid intubation. Laryngeal grade views were superior with the Airtraq and McGrath than with the Glidescope.

[Perception and communication of medical risk which implications for preoperative anaesthetic consultations?]. / La perception et la communication du risque médical. Quelles implications pour les consultations préanesthésiques?

Informing patients about available treatments, their advantages and disadvantages, as well as the associated risks, is critical to obtain an informed consent and is the responsibility of physicians, including anaesthesiologists. However, risks issues are not systematically discussed during anaesthesia consultations or are addressed in a vague and incomplete way. In order to improve communication and the quality of the informed consent, it is therefore essential to scrutinize problems linked to communication about risks. This article is based on a review of French and English literature on perception and communication about medical risks. Its objectives are for the one hand to summarize the main difficulties concerning risk communication in medicine and, on the other hand, to offer tools that can foster quality communication with patients especially during anaesthesia consultations.

Evaluation by polymerase chain reaction of cytomegalovirus reactivation in intensive care patients under mechanical ventilation.

OBJECTIVE: The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN: Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS: 23 non-immunocompromised, mechanically ventilated patients who were anti-CMV immunoglobulin G-positive. Ten immunocompromised patients with active CMV infection and 16 asymptomatic CMV seropositive non-immunocompromised patients constituted the positive and negative control groups. MEASUREMENTS AND RESULTS: The presence of CMV in blood and bronchoalveolar lavage (BAL) was evaluated by both viral cultures and polymerase chain reaction (PCR). Thirty-seven blood and 22 BAL samples were investigated. Sequential samples were evaluated in 8 patients. For PCR, a 290 bp fragment in the first exon of the immediate early 1 gene was amplified. In order to exclude inhibitors of PCR amplification, a 268 bp fragment of the beta-globin gene was concurrently amplified in all samples. Viral cultures of blood and BAL were negative in all 23 non-immunocompromised, mechanically ventilated patients. Moreover, no CMV DNA could be amplified in blood BAL samples, whereas a beta-globin amplification was observed in all samples. CONCLUSION: In a series of 23 critically ill patients under mechanical ventilation who were seropositive for CMV, no reactivation of CMV in blood or lung was demonstrated.

Respiratory physiology in upper abdominal surgery.

This article describes the pathophysiology of the respiratory system after upper abdominal surgery, emphasizing the role of respiratory muscle dysfunction. The history of current techniques to measure respiratory muscle function are reviewed. The authors describe the postoperative pattern of breathing, speculate on the physiologic mechanisms responsible and discuss the data supporting the role of reflexes arising from the abdomen and the shift of neural output to different respiratory muscles. Finally, the authors review the impact of "closed" surgical interventions such as laparoscopic cholecystectomy.

Preoperative evaluation of hemodynamic factors in cerebral arteriovenous malformations for selection of a radical surgery tactic with special reference to vascular autoregulation disorders.

After reviewing the literature with respect to hemodynamic factors in AVM the authors describe their experience monitoring the blood volume under induced arterial hypotension. They have been able to select cases which presented disorders of the vascular autoregulation of the brain and represent, for this reason, a challenge to a radical excision; in such cases they advise to remove the AVM in several programmed stages. In addition it was possible to predict the efficiency of the hypotension on AVM vessels pressure during operation enabling the surgeon in case of positive effect of the hypotension to realize more securely the haemostasis. Moreover, the authors present the first data regarding the mean circulatory time the knowledge of which seems very promising. The last 33 cases of a series of 179 radical removals have been monitored before and in some cases after operation; the knowledge of these hemodynamic factors allowed the surgical team of La Pitié to extend the surgical indications for radical removal to AVM recently considered as inoperable.

Voluntary reporting system in anaesthesia: is there a link between undesirable and critical events?

BACKGROUND: Reporting systems in anaesthesia have generally focused on critical events (including death) to trigger investigations of latent and active errors. The decrease in the rate of these critical events calls for a broader definition of significant anaesthetic events, such as hypotension and bradycardia, to monitor anaesthetic care. The association between merely undesirable events and critical events has not been established and needs to be investigated by voluntary reporting systems. OBJECTIVES: To establish whether undesirable anaesthetic events are correlated with critical events in anaesthetic voluntary reporting systems. METHODS: As part of a quality improvement project, a systematic reporting system was implemented for monitoring 32 events during elective surgery in our hospital in 1996. The events were classified according to severity (critical/undesirable) and nature (process/outcome) and control charts and logistic regression were used to analyse the data. RESULTS: During a period of 30 months 22% of the 6439 procedures were associated with anaesthetic events, 15% of which were critical and 31% process related. A strong association was found between critical outcome events and critical process events (OR 11.5 (95% confidence interval (CI) 4.4 to 27.8)), undesirable outcome events (OR 4.8 (95% CI 2.0 to 11.8)), and undesirable process events (OR 4.8 (95% CI 1.3 to 13.4)). For other classes of events, risk factors were related to the course of anaesthesia (duration, occurrence of other events) and included factors determined during the pre-anaesthetic visit (risk of haemorrhage, difficult intubation or allergic reaction). CONCLUSION: Undesirable events are associated with more severe events and with pre-anaesthetic risk factors. The way in which information on significant events can be used is discussed, including better use of preoperative information, reduction in the collection of redundant information, and more structured reporting.

[Acute myocarditis disclosing leptospirosis]. / Myocardite aiguë révélant une leptospirose.

A 44 year old patient presents with acute myocarditis and cardiogenic shock. The evolution is progressively favorable at the price of a residual involvement of the left ventricular function, evolving to a dilated cardiopathy, within three years. The responsibility of an advanced ictero-hemorrhagic leptospirosis is established. The severity of this myocarditis and the revealing characteristics of the leptospirosis are peculiar to this observation which is discussed in terms of data from the literature.

[Heart transplantation 1985. Experience of the Pitié]. / La transplantation cardiaque en 1985. Expérience de la Pitié.

Heart transplant surgery has come of age over the last four years, after 17 years of clinical application: indications have been specified, techniques systematized and treatment and post-operative follow-ups have been clarified. The results are remarkable: survival at four years is more than 80 per cent, with normal socio-familial and often professional reintegration for almost all heart transplant patients. Increased application of heart transplant surgery in the months to come will transform prognosis in patients presenting irreversible cardiac lesions, but will raise the problem of the supply of donor organs.

[A survey on recovery rooms of French university hospitals and Ile de France hospitals]. / Enquête sur les salles de réveil des hôpitaux universitaires français et des hôpitaux d'lle-de-France.

This study reports the results of a survey of post-anaesthesia recovery rooms (PARR) in French public University Hospitals (UH), and in those of the "Ile de France" (IdFH) area. The study, carried out between the 2nd and 8th of April 1990, aimed to identify the place where patients recovered from anaesthesia, and the personnel and monitoring equipment available in these places. 90% of 55 departments of anaesthesia and intensive care in University Hospitals and 94% of 34 departments in "Ile de France" Hospitals responded. A total number of 20,567 patients was collected, with 10,027 from University Hospitals. Of the latter, 31.4% recovered in the operating room or in the anaesthetic room itself; 7.5% were directly transferred to an intensive care unit (ICU), and 61.1% (10,397) were admitted to a PARR. However, 2,460 of those admitted to such a PARR were in fact admitted to a PARR without any permanent nursing staff. Overall, 45.8% of the patients were not admitted to a PARR where adequate care by nurses was available. Of the 3,540 patients anaesthetized in "Ile de France" Hospitals, 3.1% were transferred to an ICU, 25% were not admitted to a PARR, and the remaining 71.7% were. However, 35% of those admitted to a PARR were admitted to a PARR without any permanent nursing staff. Therefore 50.1% of patients anaesthetized in the "Ile de France" Hospitals did not benefit from adequate post-anaesthetic supervision. In 82% of the patients anaesthetized in University Hospitals, the lowest rates of admission to a PARR were found in patients undergoing gastrointestinal endoscopy (GIE), and ENT, ophthalmological or stomatological surgical procedures. After anaesthesia for GIE, 69% of patients recovered at the anaesthetic post and 12% were admitted to a PARR without any permanent nursing staff. In ENT-Ophthalmology-Stomatology, Gynaecology and Obstetrics, and Radiology departments, 56%, 69% and 69% of patients, respectively, recovered in the anaesthetic room or in a PARR without any permanent staff, or, for the Radiology and Obstetrics departments, sent straight back to their room. Similar results were obtained with the patients in the "Ile de France" Hospitals. Nurses were not always present in 37% and 24% of PARR in University and "Ile de France" Hospitals respectively. In the PARR, there were three ECG monitors for 4 beds, and one pulse oximeter for seven beds. It seems therefore that, despite several ministerial recommendations, not all anaesthetized patients are admitted to a recovery room after their anaesthetic.

[Surgery for lung volume reduction]. / Chirurgie de réduction de volume pulmonaire.

OBJECTIVES: To define the place of lung volume reduction surgery (LVRS) for non-bullous emphysema, to discuss the mechanisms of postoperative functional improvement and to suggest guidelines for perioperative medical management. DATA SOURCES AND EXTRACTION: The Medline data base was searched for any article (original papers, editorials, comments, reviews) published in English, French or German, from 1980 to April 1998. The key words were: lung volume reduction surgery, emphysema, respiratory failure, anaesthesia, lung transplantation. The data have been analysed to explain the physiological mechanisms underlying the postoperative improvements and to assess the risk-benefit ratio associated with LVRS. Finally, proposals are suggested for selection criteria and perioperative medical strategies. DATA SYNTHESIS: Besides pharmacological treatment and lung transplantation, LVRS is considered as an alternative treatment for patients with end-stage pulmonary emphysema. Perioperative management includes selective lung ventilation, continuous peridural analgesia and a general anaesthetic technique that can be easily reversed. Care should be taken to detect and rapidly correct dynamic hyperinflation, pneumothorax, tube malpositioning and major air leaks. In a majority of selected patients (70-80%), resection of 20-30% of lung volume produces significant clinical and physiological improvement (dyspnoea, exercise capacity, FEV1, VO2max), as well as of the quality of life that has been attributed to greater elastic recoil, reduced respiratory workload and better diaphragmatic and right ventricular function. The most common complication is prolonged air leaks. In-hospital mortality varies widely (0-20%, with a median value at 4%), depending in part on the experience of the surgical team and on the selection criteria. Several factors may predict an unfavourable outcome: advanced age, hypercapnia, diffuse emphysema, predominant airway disease and previous thoracic surgery. CONCLUSIONS: According to the favourable preliminary results and an acceptable incidence of perioperative complications, LVRS is presently considered as a new therapeutic option for some patients with respiratory failure. Future clinical studies should be focused on appropriate selection criteria, operative techniques and long term outcome data.

[Pollution and retro-pollution by the distribution system of medical gases]. / Pollution et rétropollution du réseau de distribution d'un gaz médical.

The anaesthetic machine, the recovery room or the ICU ventilator as well as any other simple oxygenation device can be accidentally supplied with a "wrong" gas, or a mixture of "wrong" and "true" gases, or a gas containing chemical impurities, as a result of one of the following causes: a) the source of the medical gas pipeline supply contains a "wrong" gas or impurities; b) the gas pipeline is polluted by a "wrong" gas or solvents, introduced during the installation or maintenance of the pipeline; c) the pipeline is polluted by a wrong gas at a point of inter-connection or cross-connection of two pipelines; d) supply of a "wrong" gas through wrong quick couplers connected to the pipeline; e) back flow of a gas in another pipeline supply through a defective gas mixer, which is today the most common cause of pipeline contamination or retropollution. It occurs with some types of mixers in case of absence or malfunction of non-return valves, associated with a pressure difference between the two gas lines. The means of prevention, recognition and emergency treatment of these events include: a) systematic removal of mixers and flowmeter-mixers from supplies when not in use; b) periodical checking of these devices for an accidental communication between the gases to be mixed; c) systematic use of an oxygen analyser for a continuous measurement of FIO2, especially when the machine is connected to the N2O pipeline supply; d) the presence of a reserve cylinder of oxygen connected to every anaesthetic machine.

[Distribution of a hypoxic gas mixture by retro-pollution of a medical gas distribution system]. / Distribution d'un mélange gazeux hypoxique par rétropollution d'un circuit de distribution d'oxygène par de l'air médical.

The authors report a case of retropollution through the defective gas mixer of a Logic O4T-IMV ventilator (Ohmeda) located in the recovery room. Due to a defective check valve inside the mixer, medical air entered into the oxygen pipeline when the O2 pressure decreased below the pressure inside the medical air pipeline. This incident resulted in episodes of hypoxic gas mixture delivery in the operating theatre, when nitrous oxide was associated with oxygen polluted with medical air. The occurrence of such an incident, rarely described so far, requires the association of several factors. It can be recognized without delay with the continuous use of an oxygen analyser.

[Peroperative perfusion of fentanyl or sufentanil: plasma concentrations and postoperative respiratory changes]. / Perfusion peropératoire de fentanyl ou de sufentanil: concentrations plasmatiques et modifications respiratoires postopératoires.

This study was designed to assess postoperatively the time course of respiratory depression due to fentanyl (F) or sufentanil (S), as well as the plasma concentrations. Seventy patients scheduled for orthopaedic surgery lasting more than 3 hours were randomly assigned to two groups, F (n = 8) or S (n = 9). Anaesthesia was induced with etomidate (0.3 mg.kg-1), droperidol (0.15 mg.kg-1), vercuronium (0.1 mg.kg-1), a loading dose of either F (10 micrograms.kg-1) or S (1 microgram.kg-1), and maintained with 60% nitrous oxide in oxygen, and an infusion of F (6 micrograms.kg-1.h-1) or S (0.6 microgram.kg-1.h-1). Mechanical ventilation was maintained postoperatively in the recovery room until the patient could be extubated. PetCO2, SpO2, fR and F and S plasma concentrations were assessed at the end of the opioid infusion, at extubation, every hour for the first 6 hours, and thereafter every 2 h for a further 10 and 18 h. Time to extubation was the same in both groups (301 +/- 141 and 307 +/- 148 min). At the time, plasma concentrations of F and S were 1.35 +/- 0.9 ng.ml-1 and 0.14 +/- 0.07 ng.ml-1 respectively. Secondary peaks in plasma concentration (78% mean increase in comparison to the previous figure) were observed in 6 patients in group F. No similar peaks occurred in group S. Mean elimination half-life was shorter with sufentanil (457 +/- 130 min) than with fentanyl (325 +/- 132 min) (not significant). The results of this study suggest that sufentanil results less frequently in postoperative secondary peaks than fentanyl.

[A study of 11 ventilators for anesthesia: laboratory testing]. / Etude de 11 ventilateurs d'anesthésie: banc d'essai.

Eleven anaesthesia ventilators were instrumentally tested under various conditions. They included: Excel and Modulus II Plus (Ohmeda); 710 and Servo anaesthesia circle 985 (Siemens); Jollytronic (Soxil) and Elsa (Engström); SA2 and Cicero (Dräger); ABT 4,300 (Kontron); Monnal A and the prototype Alys (Taema). The test circuit comprised a two compartment model lung, a pneumotachograph, a pressure gauge in the "airway". The volume was calculated as the integral of flow rate. Each machine was calibrated by the firms' technicians. Before each test, the pneumotachograph was calibrated using a 11 air syringe and the pressure gauge with a 5 cm water column. Each machine ventilated the model lung for 30 min before starting the tests. There were five tests: 1) reliability of the machine's spirometer, 2) reliability of the ventilation rate, 3) reliability of pressure measurements, 4) effect of increasing fresh gas flow on spirometry, 5) effect of increasing downstream resistances. In usual simulated ventilatory conditions, all the machines accurately delivered the setted ventilation and spirometric measurements were with minimal error only. Several ventilators (SA2, Excel, 710, Elsa, ABT 4,300) did not succeed in maintaining their performances when compliance was strongly decreased or resistance of the test lung notably increased. Resistance in the circuit during simulated spontaneous ventilation was < 3.6 cmH2O.l-1.s-1. Increasing fresh gas flow raised the minute volume delivered in six ventilators. It is concluded that, during extreme ventilatory conditions, the inspired volume must be adjusted so as to maintain the inspired tidal volume. However, ventilators which increase inspiratory time in response to an increased mechanical load cannot be adjusted by this way.

[Factors associated with laparoscopic approach for cholecystectomy, appendicectomy and inguinal herniorraphy in France]. / Facteurs associés à la coelioscopie dans les cholécystectomies, les appendicectomies et les cures de hernie inguinale en France.

OBJECTIVE: To determine on a national level the factors associated with the use of laparoscopy for digestive surgery. STUDY DESIGN: Nation wide study using a large representative sample (3 days of anaesthesia in France). METHODS: Univariate followed by multivariate analyses of data gathered in 1996 during the survey led by the French Society of Anaesthesia and Intensive care ("SFAR") including 2847 surgical procedures for cholecystectomy, appendicectomy or inguinal herniorraphy. RESULTS: Independent factors associated with the use of laparoscopy were: for cholecystectomy: age (less frequent when > or =71 years: adjusted Odds ratio [AOR] 0.4), sex (more frequent in female: AOR 1.7), ASA physical status (less frequent when > or =3: AOR 0.5), private hospital (AOR 2.0), procedure scheduled at least the night before (AOR 2.1), and use of closed circuit general anaesthesia (AOR 1.6); for appendectomy: age >15 years (AOR 1.9-2.2), female (AOR 2.1), private hospital (AOR 2.7), scheduled procedure (AOR 2.1), prolonged procedure (AOR 8.4), endotracheal intubation (AOR 16.7), and closed circuit (AOR 2.7); for inguinal herniorraphy: ASA physical status (less frequent when > or =3: AOR 0.4), private hospital (AOR 3.4), prolonged procedure (AOR 5.6), and endotracheal intubation (AOR 21.6). Association with a closed circuit was confirmed for general anaesthesia using a volatile agent (AOR 1.5). Overall, ambulatory surgery was rarely performed and used only for open procedures. Regional anaesthesia was used only for inguinal open herniorraphy. CONCLUSION: These data obtained from a large national survey confirmed the higher frequency of laparoscopy in middle aged patients, female (except for inguinal herniorraphy), without important comorbidity, in private hospitals. Laparoscopy was associated with prolonged procedures and with a change in the anaesthetic technique for appendicectomy and inguinal herniorraphy: tracheal intubation was almost constantly used. Whatever the procedure, closed circuit anaesthesia was more frequently used when surgery was performed under laparoscopy, reflecting newer equipment of the hospital, private or public.

[Factors associated with blood transfusion during anesthesia for scheduled hip or knee arthroplasty in France]. / Facteurs associés à la stratégie transfusionnelle au cours des anesthésies programmées pour arthroplastie de hanche ou de genou en France.

GOAL OF THE STUDY: To determine over a whole country what are the factors associated with an intraoperative homologous blood transfusion and with the use of autologous techniques (preoperative autologous blood donation: PABD; acute normovolemic hemodilution: ANVH; intraoperative red cell salvage: IRCS). STUDY DESIGN: National enquiry using a large representative sample (3 days of anaesthesia in France). METHODS: Univariate followed by multivariate analyses of data gathered in 1996 during the survey leaded by the French society of anaesthesia and intensive care (Sfar) and corresponding to 884 scheduled hip and knee prosthesis surgical procedures. RESULTS: Factors associated with a decreased use of PABD programme were: 1--old age and high ASA physical status; 2--procedures of short duration. By contrast, an increased use of PABD was associated with anaesthetics in which a closed circuit had been used. Except for a significant association with increasing age and with absence of PABD used, no additional factor was found to be linked with ANVH. No factor among those studied was found related to the use of IRCS. Homologous blood transfusion was more frequently used in ASA > or = 3 patients, in long duration surgeries while its use was decreased in patients with PABD (odds ratio--for reduction by PABD: 4.4 [95% confidence interval: 2.2-8.8]). Homologous blood transfusion was not related to the use of ANVH or IRCS. CONCLUSION: These data obtained from a large national survey confirm previously published studies and meta-analyses and are in agreement with current recommendations. An unexpected relation between PABD and closed circuit anaesthesia has been found.

[Halogenated anesthetic vaporizers: importance of maintenance regulations]. / Evaporateurs d'anesthésiques halogénés: importance des prescriptions d'entretien.

We report a serious dysfunction of 19 halothane vaporisers Vapor 19.3 (Dräger) which delivered a much higher concentration of agent than indicated on the dial. This inaccuracy was linked to a major corrosion of the inner layers of the vaporiser, with a deposit of zinc bromide and chloride in the bypass channel. The main cause for this dysfunction was the absence of an adequate maintenance of the vaporisers since their purchase 3 years before.

[The control of respiration in pulmonary fibrosis. The effect of O2 and CO2]. / Contrôle de la respiration dans les fibroses pulmonaires. Effets de l'O2 et du CO2.

We have studied the mode of ventilation and chemosentivity in 10 patients suffering from pulmonary fibrosis. The total lung capacity was on average 63.5 +/- 8% of the predicted. Their static compliance was 0.078 +/- 0.05 l.cm of water. The patients were studied in the prone position breathing ambient air then on hyperoxia. The response to CO2 was assessed according to the rebreathing method of Read. The results of these patients were compared with those of 11 normal subjects. The ventilation at rest was normal, with a shortened respiratory time and a Ti/Ttot ratio which was lowered. The occlusion pressure (P0.1) was very much higher than that in normal subjects. This rise was correlated with an increase in pulmonary elastance and a reduction in vital capacity. The correction of hypoxia was without effect on the respiratory parameters. In relation to normal subjects the ventilatory response to carbon dioxide in fibrotics was decreased whilst the response of the P0.1 was increased expressing central hyperactivity. In conclusion, fibrotic patients have normal ventilation in spite of an increase in inspiratory work. This normal ventilation results from hyperactivity of the respiratory centre, as in the hyperventilation induced by carbon dioxide when at rest.

[Evaluation of direct theoretical cost of passage in anesthesia recovery room]. / Evaluation du coût direct théorique d'un passage en salle de surveillance postinterventionnelle.

OBJECTIVE: To assess the direct cost of a stay in a postanaesthesia care unit (PACU). STUDY DESIGN: Standard cost study based on information gathered from staff and suppliers in accordance with government regulations and recommendations. Results reviewed by a group of anaesthesists. TYPE OF PACU: PACU working in ideal conditions with optimal safety conditions for and accommodation surgical patients). METHOD: Estimation of three cost components: 1) depreciation and maintenance costs of equipment, 2) physician and other staff wages, and 3) variable costs such as drugs and disposable devices. We computed an annual budget for three PACU which was defined according to size (4, 8 or 12 beds) and working hours. RESULTS: Fixed annual costs (staff and equipment) were 1,134,938 FF for a 4 bed room: 3,820,339 FF for an 8 bed room: and 6,481,792 FF for a 12 bed room. Variable costs per stay were 75,43 FF. The cost of a stay in an 8 bed PACU based on a rate of 3,500 stays per year therefore was 1,167 FF (87.0% for staff, 6.6% for equipment, 6.4% for variable costs).