General surgical pathologies and therapeutics, elements of anesthesia, analgesia and resuscitation

Duration

28h Th

Number of credits

Lecturer

Vincent Bonhomme, Jean-Olivier Defraigne, Jean-Luc Nizet

Coordinator

Jean-Olivier Defraigne

Language(s) of instruction

French language

Organisation and examination

Teaching in the first semester, review in January

Schedule

Schedule online

Units courses prerequisite and corequisite

Prerequisite or corequisite units are presented within each program

Learning unit contents

Anesthesia, analgesia, and resuscitation are complementary medical activities. They allow performing surgical interventions and invasive explorations, while maintaining the patient alive, or even resuscitate him or her. Anesthesia and resuscitation are also perioperative medical disciplines who take care of the patient along his or her interventional trajectory, from the preparation to the procedure to the postoperative rehabilitation, as well as during the procedure itself, insuring adequate vital functions.
The domains where anesthesia and resuscitation intervene include, among others, invasive, diagnostic or therapeutic explorations, obstetric analgesia, ... In those instances, anesthesia intends to provide patients with the ability to tolerate painful, unpleasant, or stressful interventions. Frequently, enough comfort cannot be obtained without loss of consciousness. Loco-regional anesthesia is an exception to this rule, because allowing to perform invasive procedures by rendering the conerned part of the body insensitive, without any alteration of consciousness. In addition, anesthetic medications influence homeostasis, including ventilation, respiration, cardiovascular function, and thermoregulation. The anesthetized patient is particularly vulnerable, and has to be closely monitored, so that, ultimately, his or her vital functions can be supported.
A number of therapeutic and diagnostic interventions, and particularly surgeries, are painful. They also agress the organism, and perturb homeostatis. Those disturbances occur not only during the procedure, but also after it, often for a prolonged period of time. Therefore, patients have to be closely followed, not only during anesthesia and surgery, but also during recovery. Early recovery occurs in post-anesthesia care units. Recovery and rehabilitation then continues on the ward and at home. The current mode of patient management involves increasingly shorter hospital stays, according to the concept of optimized rehabilitation. Optimized rehabilitation programs address the whole perioperative period, and are, by definition, multidisciplinary. The anesthesiologist has utmost importance in those programs.
This course is an introduction to anesthesia and resuscitation, and covers the essential knowledge necessary for all medical practitioners in this domain. It offers an averview, altogether concise and large, of the anesthesia and resuscitation science and practice, without overwhelming the student with unnecessary details or with elements that pertain to a higher degree of specialization.
The course structure refers to the clinical trajectory of a patient undergoing a procedure and beneficiating from anesthesia. The introduction defines anesthesia, the place of the anesthesiologist within patient care, his or her interactions with other medical practitioners, as well as the reasons for an anesthesia course to future medical doctors. Thereafter, the course covers the modalities and mechanisms of sedation, general anesthesia, drug-free techniques and hypnosis, and local and loco-regional anesthesia (including the caveats of using local anesthetic agents). The perioperative patient trajectory is then descirbed, including the preparation to surgery, the postoperative period, the analgesia techniques, and the enhanced rehabilitation principles. 
The table of content for the course is the following: 1. Introduction
     - Définition and generalities about anesthesia
     - The place of the anesthesiologist in patient care
     - Interactions between the anesthesiologist and other medical practitioners
     - Reasons for a course on anesthesia to future medical practitioners
2. Sedation and general anesthesia
     - Modalities
     - Mechanisms
3. Non-pharmacological techniques and hypnosis
     - Modalities
     - Mechanisms
4. Local and loco-regional anesthesia
     - Modalities
     - Mechanisms
     - Caveats of local anesthetic agents use
5. The perioperative period
     - Preparation to surgery and anesthesia
     - The postoperative period - analgesia
     - The enhanced rehabilitation concept

Learning outcomes of the learning unit

The learning outcomes are :

• Define local anesthesia, loco regional anesthesia, general anesthesia, analgesia, sedation, hypnosis, and know the differences between the notions
• Understand the progress of a general anesthesia or loco regional anesthesia
• Explain the aims and principles of the anesthetic preparation and of enhance rehabilitation principles
• Explain the principles of general anesthesia and its mechanisms
• Explain the principles of hypnosis and its use for the anesthetic management of patients
• Explain the principles of loco regional anesthesia and its mechanisms
• Describe the main loco regional blocks
• Describe the steps of general anesthesia
• Mention the different classes of medications for general and loco regional anesthesia
• Understand the basic principles of preoperative assessment
• Discuss the influence of preoperative pathologies on anesthetic care
• Formulate the risks of surgery and anesthesia
• Master the basic principles of patient monitoring during post interventional period
• Explain the principles of optimized rehabilitation
• Master the physiological basis of postoperative pain
• Explain the principles of postoperative analgesia, including the pharmacological bases

Prerequisite knowledge and skills

Co and pre-requisites are detailed in the general Master Medical formation (global course program).
 

Planned learning activities and teaching methods

This course consists of lectures, illustrated by slides, videos, and practical demonstration. The theoretical content is regularly illustrated by concrete and practical clinical examples. 

Mode of delivery (face to face, distance learning, hybrid learning)

Blended learning


Additional information:

Face-to-face teachning and/or e-learning

Recommended or required readings

Slides and course notes are made available to students on MyULg and / or on eCampus web sites.

Exam(s) in session

Any session

- In-person

written exam ( multiple-choice questionnaire, open-ended questions )

- Remote

written exam ( multiple-choice questionnaire, open-ended questions )


Additional information:

Written exam

Work placement(s)

See MSTG1003-1.

Organisational remarks and main changes to the course

Contacts

Professor: Vincent Bonhomme, Head, Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Tél: 04/366 71 80; Fax: 04/366 76 36
 
Secretariat: Jessica Debattice, Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, route 12. Tél: 04/366 71 78; Fax: 04/366 76 36, email: anesrea@ulg.ac.be

Association of one or more MOOCs

Items online