Minerva anestesiologica
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Minerva anestesiologica · Jan 2000
Case Reports[A case of tetanus: the problem of differential diagnosis].
A clinical case concerning differential diagnosis between tetanus, atropine poisoning and acute hypocalcemia is reported. A 51 year-old man has been hospitalized in ICU, coming from the emergency service of another hospital, with a diagnosis of suspected atropine poisoning (he had been under treatment with atropine collyrium 1% for same days). ⋯ Several small scars to the hands were observed (particularly a recent felon to the first finger of the rigth hand) all referable to his activity as agriculture laborer. The hematochemical examinations were performed and the slight hypocalcemia slightly laver than normal, the leukocytosis neutrophilia, apyrexia, abundant perspiration and preserved conscience in presence of thrismus and hypertonia to the inferior limbs led to the diagnosis of a possible case of tetanus.
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Minerva anestesiologica · Dec 1999
Editorial Review Comparative StudyDo we need new supraglottic devices? Clinical appraisal of the cuffed oropharyngeal airway (COPA)
The laryngeal mask airway (LMA) has been widely studied for both conventional and nonconventional uses, while the literature on the cuffed oropharyngeal airway (COPA) is still limited. The purpose of this manuscript was to review the initial appraisal of efficacy, safety, effects on hemodynamics and respiratory function, induction agents and drug requirements of this new supraglottic device. ⋯ More extensive clinical evaluations should be advocated to better understand the risk/benefit ratio of this new supraglottic device; however, it may be concluded that in healthy adults receiving general anesthesia for short procedures the COPA allows for an effective and safe control of the patient's airway and ventilation.
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Minerva anestesiologica · Dec 1999
Clinical Trial[Target controlled infusion (TCI): applications of the "TCI visual" program in anesthesia and sedation with propofol].
Systems for Target Controlled Infusion accepting not only patient' data, like Diprifusor, but also a pharmacokinetic model have not been available in Italy in the last years. Therefore a program which controls a Pilot Anesthesia Vial pump and accepts any pharmacokinetic model was developed and applied to propofol infusion for anaesthesia and sedation. ⋯ The program was easily employed, caused no inconvenience, and its use was associated with a remarkable cardiovascular stability. PE distribution was acceptable on the ground of the criteria reported in the literature. The program can be applied to drugs other than propofol, with both two and three compartment pharmacokinetic models and the anaesthetist can choose the most suitable model for the patient.
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Minerva anestesiologica · Dec 1999
[The use of bronchial fibroscopy for difficult intubations in maxillofacial surgery].
Evaluation of difficulties and modalities of tracheal intubation in maxillofacial surgery. ⋯ Among the alternative methods of elective tracheal intubation, previously evaluated as difficult or impossible using conventional laryngoscopy, the use of fiberoptic bronchoscope seems to be safest and easiest to use, although not the cheapest.
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Minerva anestesiologica · Nov 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Loco-regional block in ophthalmic surgery: single drug or drug combination with hyaluronidase? Randomized prospective study].
The aim of this study is the comparison between the use of bupivacaine alone and a mixture of bupivacaine, mepivacaine and hyaluronidase in both retrobulbar and peribulbar blockades for eye surgery. Three hundred ninety-nine consecutive adult patients scheduled for cataract surgery with regional anaesthesia were included in this prospective, randomized and partially blind study. Peribulbar blockade was performed on 199 patients (group P). Ninety-nine of them received a mixture of local anaesthetics and hyaluronidase (sub-group M), while 100 received bupivacaine alone (sub-group B). Retrobulbar blockade was performed on 200 patients (group R): 100 of them received the mixture with hyaluronidase (sub-group M), while 100 received bupivacaine (sub-group B). The interval between anaesthesia and motor blockade (onset time), the presence of residual ocular movements, the need of further anaesthesia, the quality of anaesthesia, the ocular tone, the length of anaesthesia and possible complications were registered. ⋯ Local anaesthetics mixture with hyaluronidase associated with peribulbar blockade presents the advantages of rapidity, duration and better quality without the risks of retrobulbar blockade side effects.