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N Pernoud

Publications and source records attributed to N Pernoud.

7 recordsLinked to original sources

[Reliability of the Sauvegrain and Nahum method to assess bone age in a contemporary population].

PURPOSE: The Sauvegrain and Nahum method can be used to assess bone age in addition to methods based on hand and wrist radiographs in children between 9 and 15 years of age. The aim of this study was to evaluate the reliability of this method in a contemporary population. MATERIAL AND METHODS: Elbow radiographs taken for acute trauma in 106 patients (42 girls, 64 boys) aged from 9 to 15 years old were analyzed by four radiologists. Inclusion in the study required the absence of chronic disease and previous trauma as well as parental consent. RESULTS: There was no significant difference between the four observers. The differences between bone age (BA) and chronological age (CA) were 5+/-1 months for the study group, 3.5+/-9 months for the female group, and 6+/-12 months for the male group. Bone age was overestimated compared with chronological age. There was a good correlation between CA and BA (r = 0.84). CONCLUSION: The Sauvegrain and Nahum method seems to overestimate CA in a contemporary population.

Adolescent↗

[Air embolism: an unusual complication of endoscopic retrograde cholangiopancreatography].

We report the case of a 60-year-old-woman with a myeloma who was hospitalized with a cholestasis. An endoscopic retrograde cholangiopancreatography was scheduled under general anaesthesia with oral intubation. As the biliary prothesis was placed an air embolism happened. The symptomatic treatment allowed a complete recovery. This complication is rare. The pathophysiology is not well known, we discuss the possible mechanisms.

Anesthesia, General↗

[A scale of perioperative satisfaction for anesthesia. I--Construction and validation].

OBJECTIVE: To develop and to validate a scale assessing perioperative patient's satisfaction with anaesthesia (Evan). STUDY DESIGN: Descriptive and evaluative study. PATIENTS: The study included 742 adults undergoing a surgical or a diagnostic procedure under general anaesthesia. Emergency, ambulatory and obstetrical cases were excluded. METHODS: A multidisciplinary working party produced 85 questions focusing on various pertinent areas describing satisfaction. After a validation, 25 out of them were selected for the questionnaire. The latter was completed within the 24 hours following anaesthesia by 742 inpatients. RESULTS: Item analysis showed a homogeneous distribution of the answers to each item. Main component analysis allowed to explain 53% of total variance. Six dimensions were isolated by the exploratory analysis: anxiety, embarrassment, fear, pain-discomfort, information and physical needs. Scoring method followed a simple additive model: for each dimension, the scale scored 0-100. The global score represented the sum of the six dimensions also scored 0-100. Acceptability of Evan questionnaire was satisfactory, with a spontaneous non response rate of less than 1% and a completion duration at 11 +/- 8 min. CONCLUSION: A self-completed questionnaire on patient's satisfaction with anaesthetic period was validated, allowing a global and multidimensional assessment of patient's satisfaction.

Adult↗

[A scale of perioperative satisfaction for anesthesia. II--Preliminary results].

PURPOSE: To assess the patient's experience of anaesthesia in the early postoperative period, with a self-completed questionnaire (Evan). STUDY DESIGN: Descriptive and evaluative study. PATIENTS: The study included 742 adults undergoing an elective surgical or non surgical procedure under anaesthesia. METHODS: An Evan questionnaire with 25 questions was completed 24 hours after anaesthesia by the patient. The questionnaire explored six areas, each one being marked out from 0 to 100, as the visual analogue scale. The marks were compared with consideration of age, gender, ASA physical class, type of anaesthesia, anaesthesia duration and type of surgery. RESULTS: The mean global mark was 76 +/- 9 (min-max: 34-99). Marks were lower in the youngest patients, in females, in ASA 1 patients, in longest surgical procedures, especially with regard to areas belonging to "apprehension", "pain-discomfort" and "physical needs". The lowest mark was given for the "information" provided during the pre-anaesthetic evaluation. Differences in marks occurred also between surgical specialities. CONCLUSION: The Evan questionnaire is a valuable tool for assessing the patient's opinion on the perioperative period. Further studies are required to extend its use to other fields, as ambulatory surgery.

Adult↗

[Satisfaction with anesthesia: a review of the existing instruments].

EVALUATING PATIENT SATISFACTION: In France, patient satisfaction is a criteria for health care facility accreditation. In this context, the anesthesia community has studied tools available for assessing satisfaction with anesthesia. LIMITATIONS OF AVAILABLE INSTRUMENTS: The construction of a satisfaction assessment instrument can be divided into three phases: design, sorting items, validation. Instruments available in the currently literature (1987-1997) focus mainly on pre, per- or postoperative management but little on overall patient satisfaction. As the concept of satisfaction concerns a variety of elements, many of the available instruments use a multidimensional approach. The areas explored however vary greatly depending on the author or the study. In addition, patient experience is rarely taken into consideration when designing instruments. FOUR INSTRUMENTS: Among the available instruments we retained 4 questionnaires: Patient Satisfaction with General Anaesthesia, Peri-operative Anesthesia Experience Scale, Iowa Satisfaction with Anesthesia Scale, and Amerstadam Preoperative Anxiety and Information Scale. These last 2 scales only assess patient information and anxiety. The Peri-operative Anesthesia Experience Scale alone is available in French (Echelle de Vécu périopératoire de l'Anesthésie). Patient satisfaction is also approached with specialized instruments designed to assess specific items. The most widely used scales assess anxiety and pain. Based on these findings, it is dear that the fundamental concept of patient satisfaction must be revisited. We propose a few points for thought.

Anesthesia↗