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Postoperative Analgesia for Abdominal Laparoscopic Surgery: Tap Block vs Peri-Orificial Infiltrations

Open Journal of Anesthesiology 2023年第10期13卷 187-196页

作者： Moustapha Diedhiou Ndiamé Sarr Elhadji Boubacar Ba Abdourahmane Ndong fallou galass niang Jacques Noel Tendeng Ibrahima Konaté Mohamed Lamine Fall Health Sciences Training and Research Unit (UFRSS) Gaston Berger University Saint Louis Senegal Faculty of Medicine and Pharmacy Cheikh Anti Diop University Dakar Senegal

Introduction/Purpose: The “transverse abdominal plane block” or TAP block was described by Rafi in 2001. It describes an approach to the neurofascial plane of the transverse abdominal muscle via the Jean-Louis Petit triangle and provides analgesia of the entire homolateral hemi abdomen. The aim of our study was to compare post-operative analgesia and post-operative morphine requirements between transverse abdominal plane block (TAP) and peri-orificial infiltration during laparoscopic abdominal surgery. Material and method: Prospective, randomized study conducted over a 2-year period. The study was conducted in the operating theatre of the Saint Louis Regional Hospital in Senegal. All adult patients undergoing laparoscopic abdominal surgery were included. Clinical aspects, pain scales and morphine consumption were analyzed. Results: A total of 60 patients were enrolled: 30 patients in the TAP group and 30 patients in the infiltration group. The average age was 32.9 years. The indications for laparoscopy were acute appendicitis in 50% of cases, gallbladder stones in 16% and inguinal hernia in 8%. For the TAP group, the mean numerical pain scale was 3.9 at 6 hours post-operatively and 2.1 at 24 hours post-operatively. For the infiltration group, the mean numerical pain scale was 4.3 at 6 hours post-op and 3 at 24 hours post-op. Morphine consumption at 6 hours post-op was on average 0.4 mg/patient for the TAP group and 0.9 mg/patient for the infiltration group. Discussion/conclusion: Analgesia provided by ultrasound-guided TAP block for laparoscopic abdominal surgery appears to be identical to periorificial infiltration. However, the simplicity and reproducibility of ultrasound-guided TAP block gives it a definite advantage.

关键词： Loco-Regional Anesthesia Post-Operative Analgesia Infiltrations Laparoscopy TAP-Block

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CT Scans and Delays in Diagnosis of Stroke in Senegal’s Regional Hospitals: A Multicenter Study of 655 Cases

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Open Journal of Medical Imaging 2020年第2期10卷 96-104页

作者： Hamidou Deme Nfally Badji Léra Géraud Akpo Oumou Dieng Abdoulaye Dione Diop fallou galass niang Mouhamadou Hamine Toure Ibrahima Faye Malick Diouf Aicha Ndichout Marie Mbengue Cherif Mohamadou Aidara Mamadou Ly Ousmane Sano Ndiaga Matar Gaye Ousmane Cissé Abdoulaye Ndoye Diop Aissata Ly Ba Sokhna Ba Diop El Hadj niang Radiology Department of the Aristide Le Dantec Hospital in Dakar Dakar Senegal Radiology Department of the CHNU de Fann in Dakar Dakar Senegal Neurology Department of the Fann University Hospital in Dakar Dakar Senegal Radiology Department of the Albert Royer Children’s Hospital of Fann in Dakar Dakar Senegal

Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than

关键词： Stroke CT Scans Diagnostic Delays

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Nasosinus Metastases from Breast Cancer: A Review of Two Cases

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Advances in Breast Cancer Research 2021年第4期10卷 133-140页

作者： Papa Macoumba Gaye Mouhamadou Bachir Ba Fatimatou Néné Sarr fallou niang Maimouna Mané Franck Chouamou Aurélien Chemega Radiotherapy Department of Dalal Jamm Hospital Cheikh Anta Diop University of Dakar Dakar Senegal Oto-Rhino-Laryngology Department of Fann Hospital Cheikh Anta Diop University of Dakar Dakar Senegal

Context: Breast cancer affects more than 2 million women a year worldwide. Improved treatments have made it possible to increase survival rates with more and more patients having time to develop secondary locations. Nasosinus metastases from this cancer are rare. Two recently treated breast cancer patients developed metastases to the sphenoidal and maxillary sinuses. These cases gave rise to an examination of the incidence of this disease, its diagnosis, the therapeutic means envisaged and the fate of these patients. Method: We report the diagnostic and therapeutic data of two patients suffering from breast cancer and presenting metastases at the nasosinus level, with a focus on the interest of radiotherapy in palliative care. Results: The two patients aged 56 and 60 presented in the course of their breast cancer secondary localizations in the sphenoidal and maxillary sinus confirmed by endoscopy and histology. All the cases presented massive lesions associated with other secondary bone locations in particular. After local radiotherapy and systemic chemotherapy treatment, one patient died 5 months after her diagnosis and the other was alive 16 months later. Conclusion: Nasal and sinus metastases from breast cancer are rare and have a poor prognosis as disseminated disease, they do not respond well to conventional systemic therapies even if palliative radiotherapy allows local control.

关键词： Cancer Breast Nasosinus Metastasis Senegal

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