Minerva anestesiologica
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Minerva anestesiologica · Sep 2005
Biography Historical ArticleObstetric anesthesia - then and now.
In 1947 John Bonica as new Chief of Anesthesiology at Tacoma General Hospital organized one of the first around-the-clock labor anesthesia services and when became the first chairman of the new Department of Anesthesiology at the University of Washington (1960), caudal anesthesia was the primary technique used for providing labor analgesia. In 1967 the first volume of Bonica's classic textbook ''Principles and practice of obstetric analgesia and anesthesia'' was published. The text was a comprehensive treatise that pulled together virtually everything that was known in that field. ⋯ Current obstetric anesthetic practice, though quite different from what it was 30 or 40 years ago, has its roots in the priorities, techniques and teachings of Dr. John J. Bonica.
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Minerva anestesiologica · Sep 2005
ReviewMonitored anesthesia care and loco-regional anesthesia. Vascular surgery use.
Association of locoregional techniques such as deep and superficial cervical block, lumbar epidural and/or peripheral blocks, and conscious sedation with hypnotic drugs (propofol 1-3 mg/kg/h or midazolam 2-4 mg/h) and/or opiates drugs (sufentanil 5-10 mcg or remifentanil 0.05-0.1 mcg/kg/min) is actually, the gold standard for vascular surgery. Our personal experience is based on 328 patients submitted to carotid endarterectomy, aneurysm repair and peripheral surgery.
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Minerva anestesiologica · Sep 2005
ReviewCentral venous catheters. Observations on the implantation technique and its complications.
The growing utilization of central venous catheterism is linked to the necessity of treating with an always larger number of hospitalized and nonhospitalized patients. The technological development provided us with different devices and materials for specific indications. In the majority of cases the central venous catheter is positioned through direct puncture of a central vein using Seldinger method. ⋯ The most frequent immediate complications for catheterism are the arterial puncture, pneumothorax, arrhythmias and the wrong positioning. Among the late complications there are the catheter infections correlated, catheter and vessel thrombosis. The use of a proper technique, completed by the operator's experience and the right management of the device, lead to a decrease of the risk level related to the central venous catheterism.