Impact of high fidelity simulation on perceptions and professional skills in obstetrics.

BACKGROUND: In our country, the introduction of simulation as a teaching tool for obstetric emergencies is very recent. Several studies are being developed to evaluate its benefit in the continuing education of health professionals. OBJECTIVE: To evaluate the impact of a continuing medical education program based on High fidelity simulation drills (HFS) on professional skills in obstetrics. METHODS: 91 Learners were able to benefit from HFS continuing education program. Mean job tenure was 7.94 years [1-40]. RESULTS: We were able to highlight a positive impact of level 1 with satisfaction rates of more than 90%. 92% of participants said they left with tools applicable in the function framework. Midwives and emergency physicians were the most satisfied. The general evaluation before the beginning of the training had revealed an average score of 7.12/20 [2/20-13/20]. The variance of scores initially obtained was significantly related to the profession of the learner (p <0.0001, R = 0.61). We found significant improvement in post-training scores (p = 0.0001) and a mean difference of +1.46 [-6, +8.66]. These results highlight a level 2 impact of HFS training on learners' knowledge.

Ultrasound-guided spinal anesthesia in an obese patient.

We describe the case of 62-year-old man with a body mass index of 53, hypertension, diabetes mellitus and obstructive sleep apnea that was proposed for transurethral resection of prostate under spinal anesthesia. The surface landmark-guided approach was difficult and was abandoned after many unsuccessful attempts. Spinal anesthesia was achieved in one attempt with ultrasound guidance using the midline approach at the identified level. The trajectory was determined from the transducer angle.

[Effect of intra and postoperative magnesium sulphate infusion on postoperative pain]. / Effet de l'administration intraveineuse per et post-opératoire du sulfate de magnésium sur la douleur post-opératoire.

AIM: Evaluate the effect of intra and postoperative magnesium sulphate infusion on postoperative pain in abdominal surgery. METHODS: Prospective double-blind randomized controlled study. Forty eight patients were randomly allocated to receive in the induction of anaesthesia, intraoperatively and six hours postoperatively either magnesium sulphate M Group (bolus 50 mg/kg and 0.5 g/h) or placebo (P Group). Patients were given a dose of morphine (0.1 mg/kg) IV, 45 min before the end of surgery. Sedation, pain scores, cumulative morphine consumption and adverse effects were recorded up to 24 hours postoperatively. RESULTS: The duration of anaesthesia was similar in both groups. The time of the first demand of morphine was significantly longer in M Group then in P Group, respectively (18+/-5 min vs 7+/-1 min, p=0.03). Morphine consumption was significantly higher in control group than M group on the first postoperative day (52+/-4 mg vs 30+/-3 mg, p=0.0002). Pain scores were significantly lower in M group than in P group. Serum magnesium concentration was significantly higher in the M group. The frequency of side effects was similar in the two groups. CONCLUSION: The results of the study support magnesium sulphate as useful adjuvant for postoperative analgesia in abdominal surgery.