BACKGROUND: The reuse pacemakers is a beneficial technique for patients in countries with a low economic standard of living where health care is almost non-existent. We offered to share the experience of Senegal on the reconditioning of pacemakers.
METHODS: We conducted a retrospective study over a period from January 2015 to December 2020 including all patients who benefited from a reconditioned pacemaker for primary implantation or reimplantation. The criteria for reconditioning pacemakers are the absence of dysfunction or damage and a residual battery life of more than 5 years of the pacemaker. Refurbished pacemakers are acquired either from deceased families or from extraction centers. Sterilization is carried out using phenoxypropanol + benzalkonium chloride solution, 70% ethanol and ethylene oxide.
RESULTS: We collected 161 patients during the study period, including 77 men (48%) and 84 women (52%), i.e. a M/F sex ratio of 0.94. The average age of the population was 65 years. Functional symptomatology was dominated by syncope in 54%. Electrocardiographically, 72% of patients were in complete atrioventricular block. A primary implantation was noted in 91.5% of patients. The vascular approach most used during implantation was cephalic in 49.5% of cases. In our series, we noted that 58% of patients had benefited from temporary stimulation before implantation. At implantation, single-chamber stimulation was used in 60% of patients and 46.5% of patients had programming in VVI mode. We had 5.5% major complications with 3% box infection occurring between 3 and 6 months post-implantation and 2.5% pacemaker syndrome. We noted 1 case of death linked to underlying heart disease.
CONCLUSIONS: Reconditioning of cardiac pacemakers is a safe and beneficial therapeutic strategy for patients. In Senegal, reconditioning has shown satisfactory results. In our countries this technique can be an alternative for certain patients.

OBJECTIVE: The standard process of central sterilization is crucial for the optimal functioning of the operating room. The outcome of this process is closely linked to the steps preceding the steps prior to the sterilization step itself. These steps include pre-disinfection carried out in the operating rooms and other stages, namely washing, drying and packaging, which must be performed in the central sterilization unit. In this context, this study aimed to describe the knowledge of the staff in the operating rooms and the central sterilization unit at Sahloul University Hospital in Sousse (Tunisia) in 2022, regarding the steps prior to the sterilization of reusable thermoresistant medical devices and to describe their practices in terms of compliance with these steps.
METHODS: A descriptive study was conducted from January 2022 to June 2022 with the aforementioned staff, using a self-administered questionnaire to assess their knowledge of the pre-sterilization steps and a direct observation audit of their practices with regard to these steps. Both measurement instruments were pre-tested.
RESULTS: Out of 102 self-administered questionnaires (knowledge assessment) distributed to the staff concerned, only 80 were returned and correctly filled out, giving a response rate of 78.4%. Participants\' responses regarding the order of steps prior to the sterilization were incorrect in 64% of cases. With regard to the evaluation of professional practices, 224 observations were made in the study area (practice audit). In 82% of these observations, the pre-disinfection step was confused with the washing step. The use of Betadine brushes and scrubbing pads for device washing was noted in 89.3%, along with the absence of swabbing of the canals and hollow parts in 9.4% of cases and the absence of drying of the canals with compressed air.
CONCLUSIONS: Mastery of the steps prior to sterilisation of reusable thermoresistant medical devices was insufficient in our institution, suggesting the importance of reinforcing the implementation of the procedure through a continuous training program followed by action plans.

OBJECTIVE: In order to share their knowledge, sterilization unit managers publish the results of their work in journals or at scientific conferences. The aim of Enthalpies is to list all such work in a single database. The work presented describes the construction of this database and the assessment of its feasibility for the washing step.
METHODS: The first step was to carry out a literature review. Only articles published over 10years (2013-2023) in connection with the ten-year washing stage were included. Then, each publication was categorized, coded, graded and summarized by a pharmacist-internal pair. All this data was collated in an Excel® spreadsheet, and from the data categorization a tree structure was created, enabling the interface between the user and the platform hosting Enthalpies to be understood.
RESULTS: Eighty-one publications were identified. These were categorized into 6 themes and 27 sub-themes. A reading grid was drawn up for each publication. Genially®, an online platform, was chosen to host our database.
CONCLUSIONS: Enthalpies was not designed to issue recommendations for best practice. However, by collating published scientific data, this tool can be used to assist decision-making. It represents an innovative solution for providing a literature review in the field of hospital sterilization.

This study observed the effects of oxygen supplementation, via an oxygen concentrator, on peripheral arterial blood oxygenation (SpO2) measured by pulse oximetry in anaesthetised cats undergoing spay in three different surgical positions. A total of 192 female feral cats were investigated for a large-scale trap-neuter-release program. Cats were anaesthetised with an intramuscular combination of butorphanol (0,4 mg / kg), ketamine (7-10 mg / kg) and medetomidine (0,03-0,05 mg / kg). Cats were randomly allocated to undergo spay in either Trendelenburg (TR) (70° downward head tilt), lateral (LR) or dorsal (DR) recumbency. Cats were breathing spontaneously either room air or 2 L/minute oxygen via a tight-fitting face mask. Pulse rate (in beats per minute), respiratory rate (in breaths per minute) and SpO2 (in percentage) were measured at baseline in left lateral recumbency and afterwards continuously after being positioned in allocated surgical position. At the end of surgery, cats were placed again in left recumbency, and all parameters were re-evaluated after five minutes. Overall, 33 % of cats showed severe arterial oxygen desaturation (SpO2 < 90 %) at baseline when breathing room air. When oxygen was supplemented during the procedure, arterial oxygen desaturation resolved in all cats. At the end of the procedure, 29 % of cats were hypoxaemic when oxygen was not supplemented, with an overall higher percentage of hypoxaemic cats in TR as compared to DR and LR recumbencies. All cats recovered well from surgery and were released within 24 hours post-anaesthesia. Arterial oxygen desaturation is frequent in cats anaesthetised with injectable anaesthesia for spay under field conditions. Oxygen supplementation administered via a tight-fitting mask resolved arterial oxygen desaturation in this feral cat population regardless of the surgical position and therefore oxygen supplementation is recommended in any case.
In dieser Studie wurden die Auswirkungen einer Sauer­stoffergänzung mittels Sauerstoffkonzentrator auf die Sauerstoffsättigung des peripheren arteriellen Blutes (SpO2) bei anästhesierten Katzen in drei unterschiedlichen Operationspositionen zur Ovarioektomie gemessen. Insgesamt wurden die Daten von 192 weiblichen verwilderten Hauskatzen im Rahmen eines Kastrationsprogrammes analysiert. Die Katzen wurden mit einer intramuskulären Kombination aus Butorphanol (0,4 mg/kg), Ketamin (7–10 mg/kg) und Medetomidin (0,03–0,05 mg/kg) anästhesiert. Die Katzen wurden nach dem Zufallsprinzip einer Kastration entweder in Trendelenburg- (TR) (Kopfneigung um 70° nach unten), lateraler (LR) oder dorsaler Lage (DR) unterzogen. Die Katzen atmeten spontan entweder Raumluft oder über eine eng anliegende Gesichtsmaske 2 l/Minute Sauerstoff. Die Pulsfrequenz (in Schlägen pro Minute), Atemfrequenz (in Atemzügen pro Minute) und SpO2 (in Prozent) wurden zu Beginn in der linken Seitenlage und danach kontinuierlich nach Positionierung in der zugewiesenen Operationsposition gemessen. Am Ende der Operation wurden die Katzen wieder in die linke Seitenlage gebracht und alle Parameter wurden nach fünf Minuten erneut bewertet. Insgesamt zeigten 33 % der Katzen zu Studienbeginn beim Einatmen von Raumluft eine ungenügende arterielle Sauerstoffsättigung (SpO2 < 90 %). Eine Sauerstoffzufuhr während der Operation führte zu einer optimalen SpO2 bei allen Katzen. Bei 29 % der Katzen ohne zusätzliche Sauerstoffzufuhr trat eine Hypoxie auf, wobei der Prozentsatz hypoxämischer Katzen in TR im Vergleich zu DR und LR insgesamt höher war. Alle Katzen erholten sich gut von der Operation und wurden innerhalb von 24 Stunden nach der Narkose entlassen. Während einer Injektionsanästhesie unter Feldbedingungen kommt es häufig zu einer ungenügender SpO2 bei Katzen. Mittels der zusätzlichen Sauerstoffzufuhr über eine enganliegende Maske konnte in der vorliegenden Studie bei verwilderten Hauskatzen, unabhängig von der Operationsposition, eine optimale SpO2 erreicht werden, weshalb eine Sauerstoffergänzung in jedem Fall empfohlen wird.
Cette étude a observé les effets d’une supplémentation en oxygène, via un concentrateur d’oxygène, sur l’oxygénation du sang artériel périphérique (SpO2) mesurée par oxymétrie de pouls chez des chats anesthésiés subissant une stérilisation dans trois positions chirurgicales différentes. Au total, 192 chats sauvages femelles ont été examinés dans le cadre d’un programme de piégeage, de stérilisation et de remise en liberté à grande échelle. Les chats ont été anesthésiés avec une combinaison de butorphanol (0,4 mg / kg), de kétamine (7–10 mg / kg) et de médétomidine (0,03–0,05 mg / kg) appliquée par voie intramusculaire. Les chats ont été répartis au hasard pour subir une stérilisation en position de Trendelenburg (TR) (inclinaison de la tête de 70° vers le bas), en décubitus latéral (LR) ou en décubitus dorsal (DR). Les chats respiraient spontanément soit de l’air ambiant, soit de l’oxygène à raison de 2 L/minute par l’intermédiaire d’un masque facial bien ajusté. Le pouls (en battements par minute), la fréquence respiratoire (en respirations par minute) et la SpO2 (en pourcentage) ont été mesurés au départ en décubitus latéral gauche, puis en continu après avoir été placés dans la position chirurgicale attribuée. À la fin de l’opération, les chats ont été replacés en décubitus latéral gauche et tous les paramètres ont été réévalués au bout de cinq minutes. Dans l’ensemble, 33 % des chats présentaient une désaturation sévère en oxygène artériel (SpO2 < 90 %) au départ lorsqu’ils respiraient de l’air ambiant. Lorsque de l’oxygène a été ajouté pendant la procédure, la désaturation en oxygène artériel s’est résorbée chez tous les chats. À la fin de l’intervention, 29 % des chats étaient hypoxémiques lorsque l’oxygène n’était pas administré, avec un pourcentage global plus élevé de chats hypoxémiques en décubitus dorsal qu’en décubitus latéral. Tous les chats se sont bien remis de l’opération et ont été libérés dans les 24 heures suivant l’anesthésie. La désaturation en oxygène artériel est fréquente chez les chats anesthésiés par injection pour la stérilisation dans des conditions de terrain. La supplémentation en oxygène administrée via un masque étanche a résolu la désaturation en oxygène artériel dans cette population de chats sauvages, quelle que soit la position chirurgicale et la supplémentation en oxygène est donc recommandée dans tous les cas.
Questo studio ha osservato gli effetti della supplementazione di ossigeno, tramite un concentratore di ossigeno, sull’ossigenazione periferica del sangue arterioso (SpO2) misurata mediante pulsossimetria in gatti anestetizzati sottoposti a sterilizzazione in tre diverse posizioni chirurgiche. Un totale di 192 femmine di gatto selvatico sono state indagate per un programma su larga scala di trappola-sterilizzazione-rilascio. Le gatte sono state anestetizzate con una combinazione intramuscolare di butorfanolo (0,4 mg / kg), ketamina (7–10 mg / kg) e medetomidina (0,03–0,05 mg / kg). Le gatte sono state assegnate casualmente per essere sottoposte a sterilizzazione in posizione Trendelenburg (TR) (inclinazione della testa verso il basso di 70°), laterale (LR) o dorsale (DR). Le gatte respiravano spontaneamente aria ambiente oppure 2 L/minuto di ossigeno attraverso una maschera facciale aderente. La frequenza del polso (in battiti al minuto), la frequenza respiratoria (in respiri al minuto) e la SpO2 (in percentuale) sono state misurate alla base in posizione laterale sinistra e successivamente in modo continuo dopo essere stati posizionati nella posizione chirurgica assegnata. Al termine dell’intervento, le gatte sono state poste nuovamente in posizione supina sinistra e tutti i parametri sono stati rivalutati dopo cinque minuti. Complessivamente, il 33 % delle gatte presentava una grave desaturazione dell’ossigeno arterioso (SpO2 < 90 %) al basale quando respirava aria ambiente. Quando l’ossigeno è stato integrato durante la procedura, la desaturazione dell’ossigeno arterioso si è risolta in tutte le gatte. Al termine della procedura, il 29 % delle gatte era ipossiemica quando l’ossigeno non era stato integrato, con una percentuale complessiva più alta di gatte ipossiemiche in TR rispetto alle posizioni DR e LR. Tutte le gatte si sono riprese bene dall’intervento e sono state dimesse entro 24 ore dall’anestesia. La desaturazione dell’ossigeno arterioso è frequente nei gatti anestetizzati con anestesia iniettabile durante la loro sterilizzazione. L’integrazione di ossigeno somministrato tramite una maschera aderente ha risolto la desaturazione arteriosa di ossigeno in questa popolazione di gatti selvatici, indipendentemente dalla posizione chirurgica, e quindi l’integrazione di ossigeno è raccomandata in ogni caso.

Intraperitoneal administration of local anaesthetics may reduce postoperative pain after ovariohysterectomy in dogs. The aim of this prospective, randomised, blinded, placebo-controlled clinical trial was to compare postoperative analgesia and opioid requirements after intraperitoneal and incisional administration of ropivacaine versus 0,9 % NaCl (saline). Forty-three client-owned dogs were enrolled in the study and anaesthetised using a standardized protocol that included premedication with acepromazine (0,03-0,05 mg/kg) and dexmedetomidine (0,01 mg/kg) intramuscularly. Anaesthesia was induced with propofol titrated to effect and ketamine (1 mg/kg) intravenously and maintained with isoflurane in oxygen. The analgesic regimen included carprofen (4 mg/kg) subcutaneously and morphine (0,2 mg/kg) intravenously. Depending on group assignment, each dog received either an intraperitoneal and incisional splash with ropivacaine (2 mg/kg and 1 mg/kg, respectively) (group R), or an equal volume of saline (group S). Buprenorphine (0,02 mg/kg) was administered intramuscularly once the uterus was removed. Sedation and pain were assessed 0,5, 1, 2, 4, 6 and 8 hours after extubation using a sedation scale, the short form of the Glasgow Composite Pain Scale (CMPS-SF) and a dynamic interactive visual analogue scale (DIVAS). Postoperatively, buprenorphine (0,01 mg/kg) was administered intravenously if dogs scored 6/24 on CMPS-SF. The ordinal mixed model showed no difference in pain scores between groups. Fisher\'s exact test showed no significant difference in postoperative buprenorphine requirements between group S (3/22 dogs) and group R (1/21 dogs) at the doses used. In addition, lower sedation scores were associated with higher DIVAS scores. In this multimodal analgesic protocol, ropivacaine could not improve analgesia compared to saline.
Die intraperitoneale Verabreichung von Lokalanästhetika kann postoperativen Schmerzen nach einer Ovariohysterektomie bei Hunden lindern. Das Ziel dieser prospektiven, randomisierten, verblindeten, Placebo kontrollierten klinischen Studie war der Vergleich der postoperativen Analgesie und des Opioidbedarfs nach intraperitonealer und inzisionaler Verabreichung von Ropivacain im Vergleich zu 0,9 % NaCl (Kochsalzlösung). In die Studie wurden 43 Hunde aufgenommen und nach einem standardisierten Protokoll mittels intramuskuläre Prämedikation (0,03–0,05 mg/kg Acepromazin, 0,01 mg/kg Dexmedetomidin 0,01 mg/kg) und mit auf die Wirkung eingestelltem Propofol und Ketamin (1 mg/kg) intravenös eingeleitet, sowie die Anästhesie mit Isofluran in Sauerstoff aufrechterhalten. Das analgetische Regime umfasste Carprofen (4 mg/kg) subkutan und Morphin (0,2 mg/kg) intravenös. Abhängig von der Gruppenzuordnung erhielt jeder Hund entweder eine intraperitoneale und inzisionele Verabreichung von Ropivacain (2 mg/kg bzw. 1 mg/kg) (Gruppe R) oder eine gleiche Menge Kochsalzlösung (Gruppe S). Bei Entfernung der Gebärmutter wurde zusätzlich Buprenorphin (0,02 mg/kg) intramuskulär verabreicht. Sedierung und Schmerzen wurden 0,5, 1, 2, 4, 6 und 8 Stunden nach der Extubation anhand einer Sedierungsskala, der Kurzform der Glasgow Composite Pain Scale (CMPS-SF) und einer dynamischen interaktiven visuellen Analogskala (DIVAS) bewertet. Postoperativ wurde Buprenorphin (0,01 mg/kg) intravenös verabreicht, wenn die Hunde im CMPS-SF einen Wert von 6/24 erreichten. Das ordinale gemischte Modell zeigte keinen Unterschied in den Schmerzwerten zwischen den Gruppen. Der Exakte Fisher-Test zeigte bei den verwendeten Dosen keinen signifikanten Unterschied im postoperativen Buprenorphinbedarf zwischen Gruppe S (3/22 Hunde) und Gruppe R (1/21 Hunde). Darüber hinaus waren niedrigere Sedierungswerte mit höheren DIVAS-Werten verbunden. In diesem multimodalen Analgetikaprotokoll konnte Ropivacain die Analgesie im Vergleich zu Kochsalzlösung nicht verbessern.
L’administration intrapéritonéale d’anesthésiques locaux peut réduire la douleur postopératoire après une ovariohystérectomie chez la chienne. L’objectif de cet essai clinique prospectif, randomisé, en aveugle et contrôlé par placebo était de comparer l’analgésie postopératoire et les besoins en opioïdes après l’administration intrapéritonéale et incisionnelle de ropivacaïne par rapport à du NaCl 0,9 % (sérum physiologique). Quarante-trois chiennes appartenant à des clients ont été enrôlés dans l’étude et anesthésiés selon un protocole standardisé comprenant une prémédication par acépromazine (0,03 - 0,05 mg/kg) et dexmedetomidine (0,01 mg/kg) par voie intramusculaire. L’anesthésie a été induite avec du propofol dosé à l’effet et de la kétamine (1 mg/kg) par voie intraveineuse et maintenue avec de l’isoflurane dans de l’oxygène. Le traitement analgésique comprenait du carprofène (4 mg/kg) par voie sous-cutanée et de la morphine (0,2 mg/kg) par voie intraveineuse. En fonction de son affectation à un groupe, chaque chien a reçu soit une injection intrapéritonéale et incisionnelle de ropivacaïne (2 mg/kg et 1 mg/kg, respectivement) (groupe R), soit un volume égal de solution saline (groupe S). La buprénorphine (0,02 mg/kg) a été administrée par voie intramusculaire après l’ablation de l’utérus. La sédation et la douleur ont été évaluées 0,5, 1, 2, 4, 6 et 8 heures après l’extubation à l’aide d’une échelle de sédation, de la forme courte de l’échelle composite de douleur de Glasgow (CMPS-SF) et d’une échelle visuelle analogique interactive dynamique (DIVAS). En postopératoire, de la buprénorphine (0,01 mg/kg) a été administrée par voie intraveineuse si les chiens obtenaient un score de 6/24 sur l’échelle CMPS-SF. Le modèle mixte ordinal n’a montré aucune différence dans les scores de douleur entre les groupes. Le test exact de Fisher n’a pas montré de différence significative dans les besoins postopératoires en buprénorphine entre le groupe S (3/22 chiens) et le groupe R (1/21 chiens) aux doses utilisées. De plus, des scores de sédation plus faibles étaient associés à des scores DIVAS plus élevés. Dans ce protocole d’analgésie multimodale, la ropivacaïne n’a pas permis d’améliorer l’analgésie par rapport au sérum physiologique.
L’amministrazione intraperitoneale di anestetici locali potrebbe ridurre il dolore post-operatorio dopo una ovarioisterectomia nei cani. Lo scopo di questo studio clinico prospettico, randomizzato, in doppio cieco, controllato con placebo, era di mettere a confronto l’analgesia post-operatoria e il fabbisogno di oppioidi dopo l’amministrazione intraperitoneale e incisionale di ropivacaina rispetto allo 0,9% di NaCl (soluzione salina). Quarantatré cani sono stati arruolati nello studio e anestetizzati utilizzando un protocollo standardizzato che includeva la premedicazione con acepromazina (0,03 - 0,05 mg/kg) e dexmedetomidina (0,01 mg/kg) per via intramuscolare. L’anestesia è stata indotta con propofol titolato per effetto e ketamina (1 mg/kg) per via endovenosa e mantenuta con isoflurano in ossigeno. Il regime analgesico includeva carprofene (4 mg/kg) per via sottocutanea e morfina (0,2 mg/kg) per via endovenosa. A seconda dell’assegnazione al gruppo, ciascun cane ha ricevuto un’infusione intraperitoneale e incisionale di ropivacaina (rispettivamente 2 mg/kg e 1 mg/kg) (gruppo R), oppure un volume equivalente di soluzione salina (gruppo S). La buprenorfina (0,02 mg/kg) è stata somministrata per via intramuscolare una volta che l’utero è stato rimosso. Sedazione e dolore sono stati valutati 0,5, 1, 2, 4, 6 e 8 ore dopo l’estubazione utilizzando la scala di sedazione, la versione abbreviata della Glasgow Composite Pain Scale (CMPS-SF) e la scala visiva analogica interattiva dinamica (DIVAS). Dopo l’intervento, la buprenorfina (0,01 mg/kg) è stata somministrata per via endovenosa se i cani avevano un punteggio 6/24 sulla CMPS-SF. Il modello misto ordinale non ha mostrato differenze tra i punteggi del dolore tra i gruppi. Il test esatto di Fisher non ha mostrato differenze significative nel fabbisogno post-operatorio di buprenorfina tra il gruppo S (3/22 cani) e il gruppo R (1/21 cani) alle dosi utilizzate. Inoltre, punteggi di sedazione più bassi erano associati a punteggi più alti per la DIVAS. In questo protocollo di analgesia multimodale, la ropivacaina non è riuscita a migliorare l’analgesia rispetto alla soluzione salina.

In order to implement individual instrument traceability, the evolution of laser and micropercussion markings was evaluated over 250 sterilisation cycles. A datamatrix associated with its alphanumeric code was applied on three types of instruments by laser or micropercussion. All instruments had a unique identifier affixed by the manufacturer. The sterilisation cycles corresponded to the usual cycles performed in our sterilisation unit. The laser markings had very good visibility but were quickly affected by corrosion: 12% of the markings were corroded after the 5th sterilisation cycle. Similar results were observed for unique identifiers applied by the manufacturer but with visibility attenuated by sterilisation cycles: 33% of identifiers were poorly visible after the 125th sterilisation cycle. Finally, micropercussion markings were less susceptible to corrosion but initially showed poorer contrast.

OBJECTIVE: To answer the main clinical questions asked by practitioners and men consulting for a vasectomy request.
METHODS: The CPR method was used. The clinical questions were formulated according to the PICO methodology. A Pubmed literature search for the period 1984-2021 identified 508 references, of which 79 were selected and analyzed with the GRADE grid.
CONCLUSIONS: Vasectomy is a permanent, potentially reversible contraception. It is a safe procedure. A second vasectomy is necessary in only 1 % of cases. Surgical complications (hematoma, infection, pain, etc.) are rare. The frequency of prolonged scrotal pain after vasectomy is about 5 %, and less than 2 % describe a negative impact of this pain on their quality of life. Vasectomy does not have negative consequences on sexuality. The only contraindication to vasectomy is the minor patient. Patients at increased risk of remorse are single, divorced or separated men under the age of 30. Sperm storage may be particularly appropriate for them. Whatever the reason, the law allows the surgeon to refuse to perform the vasectomy. He must inform the patient of this at the first consultation. The choice of the type of anesthesia is left to the discretion of the surgeon and the patient. It must be decided during the preoperative consultation. Local anesthesia should be considered first. General anesthesia should be particularly considered in cases of anxiety or intense sensitivity of the patient to palpation of the vas deferens, difficulty palpating the vas deferens, or a history of scrotal surgery that would make the procedure more complex. Concerning the vasectomy technique, 2 points seem to improve the efficiency of the vasectomy: coagulation of the deferential mucosa and interposition of fascia. Leaving the proximal end of the vas deferens free seems to reduce the risk of post-vasectomy syndrome without increasing the risk of failure or complications. No-scalpel vasectomy is associated with a lower risk of postoperative complications than conventional vasectomy. Regarding follow-up, it is recommended to perform a spermogram at 3 months post-vasectomy and after 30 ejaculations. If there are still a few non-motile spermatozoa at 3 months, it is recommended that a check-up be performed at 6 months post-vasectomy. In case of motile spermatozoa or more than 100,000 immobile spermatozoa/mL at 6 months (defining failure), a new vasectomy should be considered. Contraception must be maintained until the effectiveness of the vasectomy is confirmed.

BACKGROUND: For a large-scale trap-neuter-return program 119 cats were anaesthetised with an intramuscular combination of 0,03-0,05 mg/kg medetomidine, 7-10 mg/kg ketamine and 0,4 mg/kg butorphanol. Cats received intraoperative 4 mg/kg tolfenamic acid subcutaneously and before closure of abdominal wall either 2 mg/kg ropivacaine (ROPI) intraperitoneal or saline (NaCl) in equal volumes. Pain was scored one, six and 20 hours postoperative with the modified Glasgow Composite Pain Scale (mGCPS) and the modified Colorado State University Scale (mCSU). There was no significant difference in the pain scores between the two groups, but the pain scores with both pain scales were significant higher (p < 0,001 for both) six hours compared to one and 20 hours postoperative. Cut-off value on the pain scales (necessitating rescue analgesia) was exceeded in 34,5 % for mGCPS and in 39,5 % for mCSU. Cats with a higher pain score showed a lower food intake (p .
BACKGROUND: Während eines Kastrations-Rückführungsprogramm (trap-neuter-return program) wurden 119 Kätzinnen mit einer intramuskulären Kombination von 0,03–0,05 mg/kg Medetomidin, 7–10 mg/kg Ketamin und 0,4 mg/kg Butorphanol anästhesiert. Katzen erhielten intraoperativ 4 mg/kg Tolfenaminsäure subkutan und vor dem Verschluss der Bauchdecke entweder 2 mg/kg Ropivacain (ROPI) intraperitoneal oder Kochsalzlösung (NaCl) in gleichen Volumina. Die Schmerzen wurden eine, sechs und 20 Stunden postoperativ mit der modifizierten Glasgow Composite Pain Scale (mGCPS) und der modifizierten Colorado State University Scale (mCSU) bewertet. Zwischen den beiden Gruppen wurde kein signifikanter Unterschied in den Schmerzscores festgestellt, jedoch waren die Schmerzscores mit beiden Schmerzskalen sechs Stunden signifikant höher (p < 0,001) im Vergleich zu einer und 20 Stunden postoperativ. Der Cut-off-Wert auf der Schmerzskala (der eine Notfall-Analgesie erforderlich machte) wurde bei 34,5 % für mGCPS und bei 39,5 % für mCSU überschritten. Katzen mit einem höheren Schmerzscore zeigten eine geringere Futteraufnahme (p < 0,001). Die intraperitoneale Verabreichung von Ropivacain zeigte keine signifikante Verbesserung der postoperativen Analgesie im Vergleich zu intraperitonealer Kochsalzlösung. Die in der Praxis häufig verwendete Anästhesiekombination zur Kastration (Medetomidin, Ketamin, Butorphanol) der Kätzin, ergänzt mit einem nicht-steroidalen Entzündunshemmer, führte bei mehr als 1/3 aller untersuchten Katzen 6 Stunden postoperativ zu einer unzureichenden Analgesie.
BACKGROUND: L’objectif de cette étude clinique prospective, randomisée, en aveugle et d’observation était d’étudier les effets de la ropivacaïne administrée par voie intrapéritonéale pour l’analgésie postopératoire chez des chats harets femelles subissant une ovariectomie. Dans le cadre d’un programme de piégeage, de stérilisation et de remise en liberté à grande échelle, 119 chattes ont été anesthésiées par une combinaison intramusculaire de 0,03 à 0,05 mg/kg de médétomidine, 7 à 10 mg/kg de kétamine et 0,4 mg/kg de butorphanol. Les chats ont reçu en peropératoire 4 mg/kg d’acide tolfénamique par voie sous-cutanée et, avant la fermeture de la paroi abdominale, 2 mg/kg de ropivacaïne (ROPI) par voie intrapéritonéale ou du sérum physiologique (NaCl) en volumes égaux. La douleur a été évaluée une, six et 20 heures après l’opération à l’aide de l’échelle de Glasgow de la douleur composite modifiée (mGCPS) et de l’échelle modifiée de l’Université d’État du Colorado (mCSU). Il n’y avait pas de différence significative dans les scores de douleur entre les deux groupes, mais les scores de douleur avec les deux échelles de douleur étaient significativement plus élevés (p < 0,001 pour les deux) six heures par rapport à une et 20 heures postopératoires. La valeur seuil des échelles de douleur (nécessitant une analgésie de secours) a été dépassée dans 34,5 % des cas pour le mGCPS et dans 39,5 % des cas pour le mCSU. Les chats ayant un score de douleur plus élevé ont présenté une prise alimentaire plus faible (p < 0,001). L’administration intrapéritonéale de ropivacaïne n’a pas amélioré significativement l’analgésie par rapport à une solution saline intrapéritonéale. La combinaison anesthésique couramment utilisée en pratique pour la stérilisation (médétomidine, kétamine, butorphanol), complétée par des médicaments analgésiques non stéroïdiens supplémentaires, a entraîné une analgésie postopératoire insuffisante 6 heures après la chirurgie chez plus d’un tiers des chats étudiés.
BACKGROUND: Lo scopo di questo studio clinico prospettico, randomizzato, in cieco e osservazionale è stato quello di indagare gli effetti della ropivacaina somministrata per via intraperitoneale per l’analgesia post-operatoria dell’ovariectomia nelle gatte selvatiche femmine. Durante un programma di trappole, sterilizzazione e restituzione, 119 gatti sono stati anestetizzati con una combinazione intramuscolare di 0,03–0,05 mg/kg di medetomidina, 7–10 mg/kg di ketamina e 0,4 mg/kg di butorfanolo. I gatti hanno ricevuto 4 mg/kg di acido tolfenamico per via sottocutanea intraoperatoria e 2 mg/kg di ropivacaina (ROPI) per via intraperitoneale o soluzione fisiologica (NaCl) in volumi uguali prima della chiusura addominale. Il dolore è stato valutato dopo una, sei e 20 ore dopo l’intervento utilizzando la Glasgow Composite Pain Scale modificata (mGCPS) e la Colorado State University Scale modificata (mCSU). Non sono state riscontrate differenze significative nei punteggi del dolore tra i due gruppi, ma i punteggi del dolore erano significativamente più alti (p < 0,001) in entrambe le scale del dolore a sei ore dopo l’intervento rispetto a una e 20 ore dopo questo. Il valore di cut-off della scala del dolore (che richiedeva un’analgesia d’emergenza) è stato superato nel 34,5 % per il mGCPS e nel 39,5 % per il mCSU. I gatti con un punteggio di dolore più alto hanno mostrato una minore assunzione di cibo (p < 0,001). La somministrazione intraperitoneale di ropivacaina non ha mostrato alcun miglioramento significativo dell’analgesia postoperatoria rispetto alla soluzione fisiologica intraperitoneale. La combinazione di anestetici frequentemente utilizzata nella pratica per la castrazione (medetomidina, chetamina, butorfanolo), integrata con analgesici non steroidei aggiuntivi, ha dato luogo a un’analgesia insufficiente in più di 1/3 dei gatti studiati 6 ore dopo l’intervento.

The latest recommendations of 2006 on tubal sterilization reported an infectious risk of 1.5 to 2.5% for the vaginal approach. There is, however, limited literature on this approach. The primary objective of our study was to investigate the feasibility of tubal sterilization via posterior colpotomy. The secondary objectives were to study the reproducibility of this approach, the postoperative infection rate after tubal sterilization via posterior colpotomy, to evaluate its peroperative and postoperative morbidity.
This retrospective study, conducted at the Antibes\'s Hospital, included patients over 18 years of age who underwent tubal ligation with clips or bilateral vaginal salpingectomy from 2005 to 2021.
We included a total of 158 patients: 88% by clips and 12% by bilateral salpingectomy. The average operative duration was of 27 minutes. There were no infectious or postoperative complications directly related to the sterilization. There were two failures of the technique, requiring conversion to laparoscopy (1.3%) and four subsequent pregnancies (2.5%).
We were able to show low morbidity and failure rates with this surgical technique. It, therefore, does not appear to be inferior to the laparoscopic approach. Moreover, it is reproducible technique.

Faced with the proliferation of stray cats in its park, the Barthélemy-Durand public health establishment in Étampes (91), in partnership with the Société protectrice des animaux, has managed to find the right balance between health safety and a pleasant animal presence for patients and caregivers. The regulated control of free and healthy cats on the hospital site also opens up possibilities for animal mediation. Sharing experience and commitment to the animal cause.