Anesthesia, ICU and Pain Management

Céline Giustranti
04/21/2017
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The specialists in the Anesthesia, ICU and Pain Management department are responsible for the provision of anesthesia and for patient resuscitation in the operating suite. Anesthesia, via administration of intravenous medication or inhalation of anesthetic vapor, places the patient in a state comparable to sleep. It eliminates or diminishes the sensation of pain during the procedure under the safest conditions.
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The Anesthesia, ICU and Pain Management departments at both the Paris and Saint Cloud sites monitor and handle surgical patients before, during and after surgery, and medical patients during endoscopies, radiology and radiotherapy procedures.

Its activities involve:

  • Pre-anesthesia consultation to screen for risk factors and customize the preoperative assessment. Facilitating the choice between locoregional or general anesthesia.
  • Anesthesia for conventional and ambulatory surgery.
  • Postoperative monitoring – intensive care.
  • Insertion of long-tem intravenous devices for chemotherapy.
  • Hypnotherapy.
  • Nutritional management. 
  • Participation in the Committee to Combat Nosocomial Infection (CLIN).
  • Collaboration on various clinical research studies.

The safety of the anesthesia is based largely on the pre-surgical anesthesia consultation. This consultation involves collecting information on the patient’s general condition, identifying any anesthesia risk factors, customizing the preoperative anesthetic assessment, and informing the patient on the techniques to be used during anesthesia (locoregional or general anesthesia). The risks are explained and the choice is made in consultation with the patient.

In the operating suite (the operating room or recovery room), the patient is monitored constantly by specialized anesthesia and resuscitation specialists and anesthesia nurses. Each patient undergoing surgery under anesthesia is steadily monitored using ultra-efficient computerized monitoring techniques.

Beating pain is a priority

Management and treatment of pain caused by the cancer and its treatments are also among this department’s priorities.

  • Acute postoperative pain

Pain treatment begins during the surgery and continues systematically to ensure that the patient wakes up comfortable and pain-free. In the postoperative period, this treatment is adapted according to the patient’s needs as soon as pain is felt. Prevention of side effects such as nausea and vomiting is systematic.

  • Chronic pain

Cancer can cause chronic pain or residual pain requiring specific treatment. Pain management is provided by different specialists, including anesthesiologists, neurosurgeons, geriatricians and oncologists. They provide:

  • Pain management consultations.
  • Dedicated hospital beds.
  • Such procedures as specific catheter placement, in contact with nervous system or intra-spinal pathways.
  • Such surgical procedures as cementoplasty, or administration of cement between the bones.

Cementoplasty helps reduce or eliminate the pain process by consolidating pre-fracture states caused by secondary cancer lesions.

  • Orthopedics consultations are also given.

At the Paris site, three qualified anesthesiologists, a hypnotherapy anesthesiologist and a physician from the Multidisciplinary Support Care department are specifically in charge of chronic pain.

At the Saint Cloud site, two physicians from the Multidisciplinary Support Care department and an oncologist are responsible for the same activity.

There is a Pain Management Committee (CLUD) headed by an anesthesia and resuscitation specialist, a unifying factor for both sites. Its goal is to conduct discussions on ways to standardize the assessment of pain throughout the Hospital Group so as to help all health providers to work together more effectively.

Hypnotherapy 

This is a specific technique provided by a qualified anesthesiologist. A consultation is provided.

Patients receive hypnosedation for surgical procedures that are not very invasive. In this way, the side effects of general anesthesia are avoided.

Other multidisciplinary activities

  • Placement of implantable chamber or intravascular device, performed by all anesthesiologists. This takes place under local or general anesthesia. These catheters allow chemotherapy to be administered safely. It is possible to administer antibiotics via this same method as well as to take blood samples. Monitoring is provided by the department for Prevention of Infectious or Thrombotic Complications.
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