Minerva anestesiologica
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Minerva anestesiologica · Nov 1995
Comparative StudyHaemodynamic and haemoximetric aspects of experimental orthotopic liver transplantation: comparison between two different doses of propofol.
Evaluation of haemodynamic and gas exchange modifications using propofolnitrous oxide anaesthesia after ketamine induction during experimental orthotopic liver transplantation (OLT). ⋯ The VO2/DO2 relationship showed a complete O2 supply-non-dependency suggesting an adequate cellular metabolism maintenance during the anhepatic and postanhepatic phases. According to these results, the authors suggest that propofol, within the two different anaesthesiological protocols at two different doses, surely favoured a good cellular perfusion also under low cardiac output conditions, undoubtedly contributing to the realization of stress-resistant conditions and influencing a good recovery and postoperative outcome.
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Minerva anestesiologica · Nov 1995
Comparative Study[A new instrument for neuromuscular transmission monitoring: the accelerometer Tofguard. Comparative study of isometric force transduction in the assessment of pipecuronium dose-response relationship].
Pipecuronium effective doses 50,90,95 (ED50, ED90, ED95) have been obtained with the cumulative dosage method studying the influences of two different anesthetic techniques (TIVA vs isoflurane), of the patients age, of two different monitoring techniques, force transduction vs accelerometry, both evaluated by T1/TC ratio, ratio between Ist muscular response following the muscle relaxant and the values obtained before its injection, and TOFR, ratio between 4th and Ist response of every train. 33 patients, 55 years average age, 66 kgs average weight, ASA 1&2, scheduled for elective operations were anesthetized with propofol-fentanyl-N2O; tracheas were intubate under topical analgesia; maintenance of anesthesia included propofol and fentanyl or isoflurane 1 MAC. Neuromuscular monitoring included the simultaneous measurement of force of thumb adduction (FT 10 Grass) and its acceleration (Tofguard); neuromuscular blockade was evaluated by T1/TC and TOFR. Pipecuronium was administered in small decreasing boluses until 95% of T1/TC depression. ⋯ ED's values obtained with T1/TC, either with force than accelerometry, while accelerometry was more sensitive than force for all ED's. EDs values, both under T1/TC than TOF, either with force transduction than accelerometry, resulted highly correlated each other, indicating a substantial agreement between the two mechanical methods of monitoring. It is concluded that the new instrument Tofguard offers the same reliability than force transduction, with the advantages of being smaller, portable and able to calculate directly the depth of neuromuscular blockade.
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Minerva anestesiologica · Oct 1995
Case Reports[Thrombocytopenia and thrombophilic state in heparin therapy].
The authors report two clinical cases of thrombocytopenia and thrombosis which occurred during profilaxys and therapy with heparin. The mechanisms involved are reviewed and the possible therapeutic role of heparin-like drugs is discussed according to data presented in the international literature.
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Minerva anestesiologica · Oct 1995
[Adsorption of volatile anesthetics on activated charcoal. Efficiency of an experimental filter during low-flow circuit ventilation].
The inclusion of charcoal filters in the anaesthetic low-flow systems contributes to the acceleration of the kinetics of isoflurane (Forane). In fifty-four subjects, scheduled for extra- and intracranial surgery, ventilated with a low-flow system (Ohmeda Excel OAV7750 with rebreathing cassette) with a mean total flow of 0.7 1/min, the experimental charcoal cartridge showed: (a) a good adsorbent power (awakening within 5-6 minutes from the inclusion of the cartridge into the circuit) and (b) efficiency (adsorbent power unchanged until the sixth application). The use of charcoal during low-flow anaesthesia is both useful and economical.
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Minerva anestesiologica · Sep 1995
Randomized Controlled Trial Clinical Trial[Prevention of postoperative nausea and vomiting with ondansetron: a prospective, randomized, double-blind study in 90 patients].
Postoperative nausea and vomiting (PONV) are among the most common complications in surgical patients. In this prospective, double blind, parallel group study we compare the prophylactic antiemetic efficacy of ondansetron versus placebo in 90 patients undergoing general balanced anaesthesia. The patients were stratified according to the kind of surgery and randomly allocated to three treatment groups: 30 patients (Group A) received ondansetron 4 mg i.v. 1 hour before the induction of anaesthesia and placebo 1 hour before the end of surgery; 30 patients (Group B) received placebo 1 hour before the end of anaesthesia and ondansetron 4 mg i.v. 1 hour before the end of surgery; 30 patients (Group C-control group) received placebo in both the administrations. ⋯ Although the patients in Group A showed a lower incidence of PONV in comparison to the patients in Group B, such differences proved to be not statistically significant. No adverse effects in relation to drug administration were observed. We conclude that ondansetron 4 mg i.v. is safe and effective in preventing PONV in the surgical patients, particularly when administered before the induction of anaesthesia.