Minerva anestesiologica
-
Minerva anestesiologica · Nov 1998
Clinical Trial[Factors determining the successful weaning of patients with "difficult weaning"].
Weaning from mechanical ventilation is often possible in the most of patients, even if sometimes it is very difficult. For example, 25-53% of COPD patients cannot be weaned. The different modalities used do not justify this. The aim of the study was the evaluation of a further weaning trial in tracheotomized patients who underwent mechanical ventilation for at least 15 days in several ICU and in whom several attempts of weaning failed. ⋯ The conclusion is drawn weaning from mechanical ventilation can be reached also in a part of those patients who are thought not weanable with a further, prolonged and expensive weaning trial.
-
Minerva anestesiologica · Oct 1998
Randomized Controlled Trial Comparative Study Clinical Trial[Rapidity of emergence from anesthesia with sevoflurane or isoflurane].
Sevoflurane, a new anesthetic agent recently introduced in Italy, is characterized by a low coefficient of distribution blood/gas that is associated both quick narcosis and fast emergence from anesthesia. Aim of this study is the comparison between two different anesthetic methods in patients submitted to general, gynecological and orthopedical surgical operations. ⋯ On the basis of the results obtained, the conclusion is drawn that sevoflurane is more rapidly eliminated than isoflurane, but both give a good cardiocirculatory performance.
-
Minerva anestesiologica · Oct 1998
ReviewExperimental and clinical studies about the preemptive analgesia with local anesthetics. Possible reasons of the failure.
Though we fully agree with the truthfulness of the physiopathological sequences proving the phenomena of the hyperalgesia onset and therefore a prolongation of the postoperative pain, we do not believe, as stated by some authors that the studies carried out up to now, both experimental and clinical, are sufficient, the first ones to confirm the preemptive analgesia, while the second ones to be defined as contrasting and totally inadequate to confirm the preemptive analgesia effect. The lack of positive clinical data is why some authors have suggested a "revision" and a "reduction" of the word preemptive analgesia. On the contrary, we believe that differences which seem to originate from the clinical works can also be found in the experimental ones if we examine them with the same methodological principle. ⋯ However, an important characteristic that seems to come out from these works is connected to two elements strictly linked each other: the intensity and the duration of the nociceptive impulse produced and the level and the type of the induced block. In our opinion, the failure of many of these works can be attributed to the inadequacy of the analgesic levels (intensity of the block) reached and maintained in the pre-and intraoperative period. Therefore we believe that before thinking of a "review" and "reduction" of the word preemptive analgesia is necessary to take a step backward and to face again the methodological problems of the preemptive analgesia.
-
Minerva anestesiologica · Oct 1998
Case ReportsSevere accidental hypothermia successfully treated by warmed peritoneal lavage.
A case of severe accidental hypothermia (core temperature 20 degrees C) in an elderly woman successfully treated by warmed lavage of peritoneal cavity is reported. The various available rewarming techniques and some observations about the differential diagnosis between the severe hypothermic patient with cardiac arrest and the hypothermic dead person are briefly reviewed on the basis of current literature.
-
Minerva anestesiologica · Oct 1998
[Cardiopulmonary resuscitation. The effect of severe hypothermia on clinical outcome].
Evaluation of outcome after CPR in severe hypothermic patients. ⋯ Severe hypothermia seems to have a dangerous effect upon outcome after cardiopulmonary resuscitation; heating systems for body temperature could prevent this situation improving CPR results.