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Introduction: The use of adjuvants in general anesthesia (GA) is experiencing renewed interest in digestive surgery [1,2]. Objective: To provide proof of the efficacy of Ketamine and Lidocaine in the morphine saving strategy in digestive surgery. Materials and Methods: This was a randomized, single-blind, controlled trial. The study took place over a period of 6 months, from July to December 2020 at the Essos hospital center. Patients over 18 years of age scheduled for digestive surgery were divided into 3 groups: Ketamine (GK), Lidocaine (GL), control (GT). At induction of anesthetic, the GK group received IV ketamine as a bolus dose of 0.5 mg / kg; then 0.125 mg / kg / h continuously intravenously with an electric syringe pump (IVSE). The GL group received Lidocaine as an IV bolus of 1.5 mg / kg at induction anesthetic, followed by 1 mg / kg / h IVSE. The GT group did not receive any adjuvant administration. Intra and postoperative opioid consumption, intensity of postoperative pain, area of peri-scarring hyperalgesia and incidence of postoperative nausea and vomiting (PONV) were listed. A probability P <0.05 was used as the significance level. Results: During the survey period 60 participants met the inclusion criteria: 27 for the GK group, 15 for the GL group and 18 for the GT group. The average age of the participants was 55 with extremes ranging from 18 to 65. The sex ratio was 2.5 in favor of men. The majority of the workforce was in the ASA 2 class (57.1%). The main indications for surgery were hemicolectomy (33.3%), bilio-digestive bypass (19%) and cholecystectomy (14.8%). Ketamine and Lidocaine reduced intraoperative fentanyl consumption by 67.7% and 42.85%, respectively (P <0.001). The postoperative morphine savings were remarkable with Ketamine and Lidocaine in the order of 14.8mg and 20mg respectively (P = 0.001). The numerical scale was significantly improved with Ketamine and Lidocaine in the first 24 hours postoperatively (P = 0.001). The area of pericicatricial hyperalgesia was limited to the operative site for all participants in the GK and GL groups (P <0.001). The incidence of PONV was reduced in the test groups in a comparable manner (p = 0.045). Conclusion: The use of ketamine and IV lidocaine in the morphine sparing strategy in digestive surgery has been shown to be effective. The benefit / risk balance argues in favor of the use of these molecules in countries with low per capita income.

The general objective of this study was to assess the impact of the recognition of warning, signs of ischemic stroke, on the reduction of emergency admission times and the improvement of the prognosis of the patient suffering from ischemic stroke in the emergency department of the Yaounde central hospital. Methods: This was a prospective study with a descriptive and analytical aim carried out in the medical emergency department of the central hospital of Yaounde over a period of 3 months, going from October to December 2020. All patients admitted to emergency departement, during this period, for a diagnosis of ischemic stroke confirmed by a brain CT scan were included in the study. The data was collected on a survey sheet divided into 3 sections: the patient, the assessment of his knowledge and his reaction to the stroke. The variables studied were socio-demographic data, cardiovascular risk factors and warning signs of stroke. Data analysis was conducted with Census and Survey Processing System (CSPRO). Results: During the study period, 62 patients met the inclusion criteria. Adults under 50 (41.94%) were the most represented age group. The mean age of the patients was 52.3 years with ranges ranging from 36 to 82 years. The sex ratio was 1.38 in favor of women. The most common unmodifiable cardiovascular risk factor was age over 55 years 44%. High blood pressure 61% was the most common modifiable risk factor. More than half of the study population had no knowledge of How to cite this paper: