Bøger af Salma Ketata

A analgesia pós-operatória (APO) tem um papel importante na avaliação das práticas profissionais e desempenha um papel fundamental na redução da morbilidade e mortalidade pós-operatórias.Realizámos um estudo prospetivo observacional para avaliar a analgesia pós-operatória em doentes operados no departamento de cirurgia visceral do Hospital Universitário Habib Bourguiba, em Sfax, Tunísia.Foram incluídos 60 pacientes com idade superior a 18 anos durante um período de 15 dias.No pós-operatório, a analgesia monomodal foi a mais utilizada, principalmente o paracetamol intravenoso. Na cirurgia abdominal major, a analgesia epidural pós-operatória foi utilizada de forma sistemática. Os doentes que beneficiaram desta técnica ficaram completamente satisfeitos. No final do internamento, a dor mínima era a mais marcada e a maioria dos doentes estava satisfeita com os cuidados prestados no serviço.

During laparoscopic surgery, insufflation of carbon dioxide for the creation of Pneumoperitoneum (PP) causes multiple hemodynamic variations. The aim of our study is to investigate the efficacy of magnesium sulfate in preventing adverse hemodynamic reactions associated with PP in patients undergoing laparoscopic cholecystectomy.Methods: This was a prospective, randomized, double-blind clinical trial conducted at the Department of Anesthesia and Intensive Care, CHU Habib Bourguiba Sfax. The study included seventy patients aged between 20 and 65 undergoing laparoscopic cholecystectomy, who were randomized into two groups containing 35 patients each.The Mg2+ group: received 50 mg/kg intravenous magnesium sulfate diluted in 100 ml saline prior to anesthetic induction.Group S: received the same volume of 0.9% saline before anesthetic induction.Results and conclusion: Magnesium sulfate administered prior to PP insufflation attenuated the unfavorable hemodynamic response and provided hemodynamic stability.

Postoperative analgesia (PSA) plays an important role in the evaluation of professional practices, and plays a key role in reducing postoperative morbidity and mortality.We conducted a prospective observational study evaluating postoperative analgesia in patients operated on in the visceral surgery department of CHU Habib Bourguiba Sfax Tunisia.We included 60 patients aged over 18 years over a 15-day period.Postoperatively, monomodal analgesia was most commonly used, mainly intravenous paracetamol. In major abdominal surgery, postoperative epidural analgesia was used systematically. Patients who benefited from this technique were entirely satisfied. At the end of the hospital stay, pain was least marked, and the majority of patients were satisfied with their care in the department.

Ventilator-associated lung disease (VAPD) is a public health problem and a frequent and serious complication of assisted ventilation. This study consisted of an epidemiological analysis of ventilator-associated pneumonia (VAP), with the aim of assessing its frequency, risk factors, isolated germs and excess mortality factors, in order to propose preventive measures to improve the management of intensive care patients. This retrospective study covered 115 patients hospitalized in the surgical intensive care unit at Tahar Sfar Madia Hospital. 40 patients suffered from PAVM, representing an incidence of 35%, of which 62.5% were early PAVM and 37.5% were late PAVM. The risk factors for PAVM found in our study were emergency department referral, thoracic trauma with pulmonary contusion and enteral feeding. Mortality in the PAVM group was very high, around 45%. The prognostic factors found were age > 60 years, presence of tare, APACHE II score ¿ 15, early PAVM, unsuitable first-line antibiotic therapy and presence of complications.