Minerva anestesiologica
-
Minerva anestesiologica · Sep 2000
Randomized Controlled Trial Clinical TrialAnaesthesia with desflurane-nitrous oxide in elderly patients. Comparison with isoflurane-nitrous oxide.
Desflurane is a new volatile anaesthetic, very little soluble. We wished to compare efficacy, safety, and emergence and recovers; profiles of desflurane-N2O versus isoflurane-N2O anaesthesia in elderly patients. ⋯ Early recovery in elderly patients is faster after desflurane than isoflurane anaesthesia; this might contribute to increased requirement of postoperative analgesia. Occurrence of adverse event is comparable between the two anaesthetics.
-
Minerva anestesiologica · Sep 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe effects of preemptive intravenous versus preemptive epidural morphine on postoperative analgesia and surgical stress response after orthopaedic procedures.
The purpose of this study was to evaluate the effect of pre-emptive intravenous versus pre-emptive epidural morphine on both postoperative analgesic consumption and surgical stress response. ⋯ Although pre-emptive epidural morphine has failed to decrease postoperative analgesic consumption, it has been able to suppress the surgical stress more significantly than intravenous morphine and a saline control.
-
Minerva anestesiologica · Sep 2000
[Postoperative pain management. Aims and organization of a strategy for postoperative acute pain therapy].
The Health Services, not only the Italian one, is under pressure because of request for improving treatment quality and the financial need for reorganization and cost-saving. It's required a rationalization of intervention, together with a careful choice of the best and cheapest techniques and the demonstration of their efficacy. The anaesthesia service activity, in a period of cost rationalization and funds restriction should be aimed to appropriate outcome measures corrected by both patient's risk factors and surgical-anaesthesiological case-mix. ⋯ It should be emphasized a collaborative, interdisciplinary approach to pain control, assessment and treatment, including all the members of the health care team, with an input from the patient and a protective collaboration from the Institution. The development of a postoperative care team must be considered as part of the largest project for "a Painfree Hospital". It represents a keystone of a Institutional Quality Assurance Plan for health care providers, patients (customs) and Institution.
-
Minerva anestesiologica · Sep 2000
Randomized Controlled Trial Comparative Study Clinical Trial[Comparison of 0.125% bupivacaine and 0.2% ropivacaine in obstetric analgesia].
This comparative study of low doses of ropivacaine was conducted in order to identify the most effective form of analgesia during labour with the aid of supplementary low doses of fentanyl and clonidine. 60 ASA I and II parturient primipares who had asked for epidural analgesia were randomly assigned to two groups. Group R was given 5-7 ml 0.2% ropivacaine and Group B 0.125% bupivacaine with both groups receiving 75 ng clonidine and 50 ng fentanyl with their first bolus of local anaesthetic. The parameters measured included the speed and spread of the sensory blockade and the scale of any motor blockade. ⋯ Optimum analgesia was achieved in Group R, the level of analgesia was insufficient or barely sufficient in 3.3% of cases. There was no Apgar score < 7 in either group. It was therefore concluded that both bupivacaine and ropivacaine offer excellent analgesia during labour and have no significant side effects on mothers or babies.
-
Friedreich's ataxia is an inherited neuromuscular disorder often associated with significant cardiac disease and requiring special care during anaesthesia because of increased sensitivity to muscle relaxants. We report a 37 years old female patient with Friedreich's ataxia who underwent anaesthesia for total hip replacement because of degenerative hip arthritis. Anaesthesia was induced with alfentanil and propofol. ⋯ Anaesthesia was maintained with propofol infusion and intermittent bolus doses of alfentanil. At the end of the procedure recovery from anaesthesia was fast and uneventful. When there is no absolute indication for neuromuscular blocking agents as its the case for many orthopaedic operations, avoiding these drugs would simply avoid many potential complications due to muscle relaxant use in this group of patients.