Minerva anestesiologica
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Minerva anestesiologica · Jul 1998
Randomized Controlled Trial Clinical TrialIncidence of hypotension and bradycardia during integrated epidural/general anaesthesia. An epidemiologic observational study on 1200 consecutive patients. Italian Study Group on Integrated Anaesthesia.
Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study. ⋯ Randomized, controlled studies should be advocated in order to compare the incidence of hypotension and bradycardia during integrated anaesthesia and during epidural block alone. Our results demonstrated that the use of integrated epidural/general anaesthesia produces an incidence of perioperative hypotension and bradycardia similar to that reported when central blocks are used alone.
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Minerva anestesiologica · Jun 1998
Randomized Controlled Trial Clinical Trial[The effects of a dose of epidural clonidine combined with intrathecal morphine for postoperative analgesia].
To evaluate the effectiveness of a single bolus of epidural (ED) clonidine (C) associated with intrathecal morphine (M) on postoperative analgesia after cesarean section (CS). ⋯ A single ED bolus of C 150 micrograms after CS significantly enhances and prolongs the analgesic effect of M 250 micrograms without important side effects.
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Minerva anestesiologica · May 1998
[Appropriate arterial pressure management for subarachnoid hemorrhage ].
A correct assessment of arterial pressure state during SAH is one of most critical issue in neurologic intensive care. It is important to evaluate two different clinical conditions: a) during SAH when the aneurysm is open, b) after aneurysmal clipping or embolization. The authors propose pressure parameters appropriated for SAH according to the timing of treatment so as to prevent and treat SAH complications.
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Minerva anestesiologica · May 1998
Review[Strategy for intensive care in patients with subarachnoid hemorrhage].
Severe medical complications account for 20-30% of all deaths in patients with subarachnoid hemorrhage. High quality of intensive care is needed to prevent and correct pulmonary complications and electrolyte disturbances. ⋯ Extensive monitoring is necessary to achieve adequate observation in the perioperative period and safe treatment of vasospasm. A multidisciplinary approach in a critical area with intensive and sub-intensive beds, based on the cooperative role of neurosurgeons and anesthetists/intensivists, could improve the medical care, reducing complications, ICU stay and costs.
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Minerva anestesiologica · May 1998
Review[Hydrocephalus and rebleeding in subarachnoid hemorrhage].
The main features of rebleeding and post-haemorrhagic hydrocephalus in case of subarachnoid haemorrhage following the rupture of an intracranial aneurysm are presented. In both cases frequency, causes, clinical events, prevention and therapy are discussed.