Introduction: Plasma exchanges appear to be an important therapeutic advance for certain serious diseases poorly controlled by conventional treatments. This technique consists of subtracting a large plasma volume in order to remove from the body molecules responsible for pathologies, including antibodies and to restore the figurative elements of the blood. The plasma thus extracted is replaced volume for volume by substitute liquids of variable composition according to the indications or the centers.
Objective: The aim of this work is to focus on the experiment of the Blood Transfusion Center of the Mohammed V Military Training Hospital in Rabat on plasma exchanges.
Material and Method: the study is carried out on 153 plasma exchange sessions were carried out over a period of 4 years from 2003 to 2007 in 38 patients aged between 13 and 50 years. The procedures were carried out with batch flow separators often in the intensive care unit or in the departments with monitoring by monitoring.
Result: The majority of exchanges were carried out for neurologically expressed diseases (77%) followed by kidney diseases (10%), metabolic diseases (5%), vasculitis and system diseases (5%) and hematological diseases (3%).
Conclusion: This therapeutic technique has developed rapidly in recent years thanks to a better control of extracorporeal circulation problems, the performance of cell separators, the accessibility of semi-industrial blood products, a better knowledge of the pathophysiology of a number of conditions in particular in the field of immunology.

Back ground: An Audit to study pain after laparoscopic cholecystectomy with the use of non-opioid analgesics.
Patient and Methods: Hundred and nine patients were enrolled in this study that underwent elective laparoscopic cholecystectomy. Aged between 20 – 55 years, patients of either gender were enrolled in this prospective observational study. Seven patients were excluded from the study because of the conversion of laparoscopic procedure to open cholecystectomy and two patients were lost to follow-up. These patients were instructed and taught how to use the Numerical Pain Rating Scale (NPRS) for assessment of pain at rest, during deep breath and on movement. Pain score at rest, deep breath and movement including (Mild, Moderate and Severe pain), dynamic pain, breakthrough episodes of pain and time to discharge post surgery were recorded
All patients were interrogated for acute pain for the postoperative pain score at rest, deep breathing, and movement at 2, 6, and 12h on the first day of surgery according to the NPRS.
The pain was also classified into mild, moderate, and severe at rest, deep breath, and movement, respectively, at 2, 6, and 12h on the first day of surgery (no pain, NPRS = 0; mild pain, NPRS = 1–3; moderate pain, NPRS = 4–6; and severe pain, NPRS = 7–10).
Dynamic pain was defined as the difference in the NPRS scores between rest and deep breathing, which is >2 points. The timing of first episode of breakthrough pain and number of episodes of breakthrough pain on postoperative day 1 and time to discharge from the day of surgery were recorded
Results: In this study, 50 patients were enrolled, who underwent elective laparoscopic cholecystectomy. We found that 35 of the patients had mild pain at restate any time interval. Only 1 patient had severe pain with deep breath at 1h hours after surgery. 9 patients had moderate pain with movement at 3 hours and 5 patients had severe pain with movement at 8 hours after surgery.
Conclusion: Maximum pain scores were found at 8 hours. Episodes so an optimal analgesic control is warranted in such subset of patients. The time to discharge of patient’s was positively correlated to the pain scores of postoperative day 1.