Minerva anestesiologica
-
Minerva anestesiologica · Mar 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical and neuropsychologic evaluation of different anesthesia techniques (propofol vs isoflurane) in general surgery].
Different anaesthetic techniques in the perioperative period (induction and maintenance of anesthesia, recovery and 48 postoperative hours) were evaluated in 200 patients undergoing general surgery. After randomization, results from 4 groups, were clinically and statistically compared according to the anesthetic techniques performed (propofol + fentanyl in air/O2; isoflurane + fentanyl in air/O2; propofol + fentanyl in N2O/O2; isoflurane in N2O/O2). The results show that anesthesia without N2O is difficult and fentanyl isn't the ideal analgesic; but no difference was found between the anesthetic techniques in quality of induction and maintenance, speed of recovery and quality of postoperative period.
-
Minerva anestesiologica · Jan 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Post-tetanic count after 50 and 100 Hz tetanic stimulation for monitoring deep neuromuscular blockade with vecuronium].
For monitoring of vecuronium profound neuromuscular blockade post-tetanic count (PTC) following tetanic stimulation at frequency of 50 and 100 Hz was employed in 25 ASA I-II patients submitted to elective surgery, to evaluate the differences between the two patterns of stimulation and the possible clinical utility of the latter pattern of stimulation. The drugs employed for anaesthesia were: diazepam 0.15 mg kg-1 in premedication, thiopental 4-5 mg kg-1 for induction, suxamethonium 1.5 mg kg-1 for tracheal intubation. Anaesthesia was maintained with N2 + O2 (2:1). ⋯ The first dose of vecuronium (0.06 mg kg-1) was administered at recovery from suxamethonium (clinically evaluated) and the other doses (0.06 mg kg-1) when the third response to a train of four appeared. The results show that the PTC following 100 Hz tetanus was greater than the PTC following 50 Hz tetanic stimulation (P < 0.01). The results also show that PTC following 100 Hz tetanus leads to underestimate neuromuscular blockade; yet maybe it has any clinical employment in selected surgical situations such as middle ear and eye surgery, microvascular surgery, neurosurgery.
-
Minerva anestesiologica · Jan 1994
[Automatic fluid control during high-flow continuous hemofiltration: the Equaline system].
To describe the use of an automatic fluid control system, Equaline, during high flux continuous hemofiltration. ⋯ Equaline system was able to maintain intravascular volume in the face of high ultrafiltration rate avoiding clinically important discrepancies between ultrafiltrate formation and fluid replacement. We conclude that PDCVVH management is greatly improved with use of such servo-controlled feedback system.
-
Minerva anestesiologica · Jan 1994
Case Reports[An anesthetized anesthesiologist tells his experience of waking up accidentally during the operation].
We report the recollections of an anaesthesiologist who experienced urogenital surgery under balanced anaesthesia which was insufficient to prevent awareness during a part of the procedure. The patient was hard apprehensive before surgery and neither sedative nor amnesic drugs were done as premedication. He received an Innovar, thiopentone, suxamethonium, nitrous oxide/oxygen sequence for intubation. ⋯ According to him the worst aspect of the experience was desperately wanting to move or speak and being unable to do so. In the event of unexpected awareness, the anaesthesiologist must deal with the patient in an honest and forthright manner. Failure to do so lead to dire psychological consequences for the patient and expensive malpractice litigation for the anaesthesiologist.
-
Minerva anestesiologica · Jan 1994
[Peridural administration of low-dose morphine on demand following major abdominal surgery].
The present report deals with 20 patients undergoing major abdominal surgery, in whom a postoperative antalgic regimen has been administered on demand by means of morphine via lumbar peridural catheter. We injected 3 mg as the first dose after surgery and subsequent 2 mg doses when required. In each patient we controlled regularly for 72 hours the following: respiratory function, antalgic effects and side effects. We concluded that this technique is fit to obtain good analgesia with rare and mild side-effects.