Annali italiani di chirurgia
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Randomized Controlled Trial Comparative Study
[Two strategies of morphine administration on the control of post-surgical pain after anesthesia with remifentanil].
The post-operative pain (POP) is accompanied by autonomic, psychological and behavioural responses which can result in a significant increase in morbidity and mortality. The purpose of this study was to compare the efficacy and safety of intravenous bolus administration of morphine versus subcutaneous administration. ⋯ Our study suggests that whether intravenous or subcutaneous administration of morphine, both simple and economical analgesic techniques, they are able to guarantee the same quality control of POP in patients undergoing abdominal surgery.
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Comparative Study
The prognostic significance of thoracic and abdominal trauma in severe trauma patients (Injury severity score > 15).
The aim of the present study was to assess the prognostic significance of thoracic and abdominal trauma in severely injured patients. A retrospective analysis was performed based on data from the period from March 1 2006 to December 31 2007, taken from the Trauma Registry of the University Hospital "SantAndrea" in Rome. A total of 844 trauma patients were entered in a database created for this purpose, and only patients with an Injury Severity Score (ISS) > 15, (163 patients, 19.3%), were selected for the present study. ⋯ In Group B mortality and morbidity rates were 369% (17 patients) and 43.5% (20 patients) respectively. It was shown that the presence of both thoracic and abdominal injuries significantly increases the risk of mortality and morbidity. In patients with predominantly thoracic injuries, NISS proved to be the more reliable score, while ISS appeared to be more accurate in evaluating patients with injuries affecting more than one region of the body.