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Anesthesia during deployment of a military forward surgical unit in low income countries: A register study of 1547 anesthesia cases


Autoři: Quentin Mathais aff001;  Ambroise Montcriol aff001;  Jean Cotte aff001;  Céline Gil aff001;  Claire Contargyris aff001;  Guillaume Lacroix aff001;  Bertrand Prunet aff002;  Julien Bordes aff001;  Eric Meaudre aff001
Působiště autorů: Department of Anesthesiology and Intensive care, Military Hospital Sainte-Anne, Toulon, France aff001;  Service Médical de la Brigade des Sapeurs Pompiers de Paris, Paris, France aff002;  French Military Health Service Academy Unit, Ecole du Val-De-Grâce, Paris, France aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223497

Souhrn

Background

Military anesthesia meets unique logistical, technical, tactical, and human constraints, but to date limited data have been published on anesthesia management during military operations.

Objective

This study aimed to describe and analyze French anesthetic activity in a deployed military setting.

Methods

Between October 2015 and February 2018, all patients managed by Sainte-Anne Military Hospital anesthesiologists deployed in mission were included. Anesthesia management was described and compared with the same surgical procedures in France performed by the same anesthesia team (hernia repair, lower and upper limb surgeries). Demographics, type of surgical procedure, and surgical activity were also described. The primary endpoint was to describe anesthesia management during the deployment of forward surgical teams (FST). The secondary endpoint was to compare anesthesia modalities during FST deployment with those usually used in a military teaching hospital.

Results

During the study period, 1547 instances of anesthesia were performed by 11 anesthesiologists during 20 missions, totaling 1237 days of deployment in nine different theaters. The majority consisted of regional anesthesia, alone (43.5%) or associated with general anesthesia (21%). Compared with France, there was a statistically significant increase in the use of regional anesthesia in hernia repair, lower and upper limb surgeries during deployment. The majority of patients were civilians as part of medical support to populations.

Conclusion

In the context of an austere environment, the use of regional anesthesia techniques predominated when possible. These results show that the training of military anesthetists must be complete, including anesthesia, intensive care, pediatrics, and regional anesthesia.

Klíčová slova:

Anesthesia – General anesthesia – Local and regional anesthesia – Orthopedic surgery – Surgical and invasive medical procedures – Surgical repair – Epidural block – Femoral block


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