This study suggests a high risk of failure when using the technique currently taught in the French army. A lateral approach into the 4th ICS could decrease this risk. The results of this study must be validated in patients presenting tension pneumothorax.

The negative inotropic and lusitropic effects induced by lidocaine were more important than that of mepivacaine and may involve an impairment of intracellular Ca2+ handling.

Retrospectively, a cardiovascular index predicted unexpected intraoperative movements. Prospective validation is needed.

No abstract

A 75-yr-old man who presented with stenotic lower-third esophageal cancer was anesthetized for iterative palliative endoscopic dilatation. In the operating room, a case of welltolerated new onset rapid atrial fibrillation (AF) (170 beatsÁmin -1 ) was diagnosed. This diagnosis prompted us to postpone the procedure. In the morning, an electrocardiogram revealed the absence of cardiac rhythm abnormalities; however, fluid expansion and intravenous administration of magnesium sulfate 1.5 g proved ineffective. In the recovery room, the anesthesiologist performed a transthoracic echocardiogram (TTE) that revealed an extrinsic compression of the posterior left atrial wall by a circular hyperechogenic structure (Fig. 1, panel B). A computed tomography scan confirmed that the structure was an esophageal stent that had been invaded by the tumour (Fig. 2). The left ventricular ejection fraction was approximately 50%, which allowed the physicians to attempt cardioversion by intravenous administration of amiodarone 300 mg. The patient's heart rate normalized within one hour, and general anesthesia was then performed.New onset AF with poor tolerance or uncontrolled heart rate in the preoperative setting is a rare condition, and