Minerva anestesiologica
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Minerva anestesiologica · Dec 1992
Comparative Study[National survey on the action taken at the intensive care units to control hospital infections].
In 1990, a survey of recommended infection control practices in ICUs was carried out in 11 European countries. At the European level, 1005 ICUs returned the questionnaire (response rate = 61.2%), while in Italy only 129 ICUs out of 289 answered (response rate = 45%). The survey showed that the diffusion of recommended infection control practices in Italian ICUs was similar to other European countries, even if infection control resources at the hospital level were scarce: a hospital infection control program was launched ad necessary resources were available in only 14% of the responding Italian ICUs.
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Minerva anestesiologica · Nov 1992
[Aspiration syndrome in cesarean section. Our experience from 1980 to 1990].
In the last twenty years maternal mortality attributed to anaesthesia has decreased. Inhalation of gastric contents is the commonest cause in patients undergoing cesarean section; in fact pregnant women are considered "high risk" because of gravidic modifications. In this retrospective study of 10017 caesarean sections performed under general anaesthesia in our institution between January 1980 and December 1990, we evaluated the frequency of this syndrome (7 cases = 1:1431). ⋯ All these seven patients were admitted at our recovery room for less than 5 days; aspiration pneumonitis occurred in only three patients. Our results suggested that induction of anaesthesia with high doses of thiopental reduces complications related to light anaesthesia, including vomiting. At a dose of 5-6 mg/kg thiopental didn't produce any significant neonatal depression as documented by Apgar scores.
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Postoperative shoulder pain should be adequately treated not only because of the high severity of the symptomatology often observed, but also because pain and muscle contraction render impossible an early rehabilitation programme. Regional anaesthesia, by virtue of its beneficial effects on the pathophysiology of pain and its influence on the rehabilitative problems of shoulder surgery, is the most adequate technique for the control of postoperative pain.
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The safe conduct of anesthesia and intensive care for heart transplant recipient requires a sound understanding of the pathophysiology of advanced cardiac failure through knowledge of anesthetic and cardiovascular pharmacology and an appreciation of the altered physiologic and pharmacologic responses of acutely denervated and transplanted heart. The most serious dysfunction is acute distension and failure of the transplanted heart's right ventricle. Hemodynamic monitoring and TEE are useful in the management of inotropic support during heart transplantation.
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Minerva anestesiologica · Oct 1992
Randomized Controlled Trial Clinical Trial[Different anaesthetic technique: conduction and outcome from multidisciplinary procedures].
Different anesthetic techniques in perioperative times (intraoperative induction and maintenance of anaesthesia, recovery and 24 and 48 postoperative hours) were evaluated in 100 patients underwent general surgery. After randomization, 4 groups were clinically and statistically compared according to anesthesia technique (propofol + fentanyl in air/O2; isoflurane + fentanyl in air/O2; propofol + fentanyl in N2O/O2; isoflurane in N2O/O2). The results show that conduction of anesthesia without N2O is difficult; but the adequacy of induction and maintenance of anesthesia, the speed of recovery and the quality in the postoperative period show no difference in the anesthesia techniques used.