Minerva anestesiologica
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Minerva anestesiologica · Jul 1992
[Sub-arachnoid anesthesia with Sprotte and Whitacre types atraumatic needles in cesarean section].
Fifty patients undergoing cesarean section with spinal anaesthesia received hyperbaric 1% bupivacaine at the L1-L2-, L2-L3 or L3-L4 interspace. Intrathecal injection was performed with a 24 gauge Sprotte needle in 35 patients and a 25 gauge Whitacre needle in 15. Successful anaesthesia was obtained in 49 patients (98%). ⋯ All newborns were in good condition (Apgar score greater than or equal to 9). No post-spinal headache was reported. Our experience confirms the smaller incidence of headache with the pencil point needles compared with conventional needles, the effectiveness of the method and the pleasurableness of the procedure for the mothers.
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Spinal cord stimulation (SCS) of the low thoracic spinal epidural space was carried out in 11 patients with pain from peripheral arterial disease of the lower limbs. Conservative treatment or vasoactive drugs also failed. ⋯ Exercise tolerance as measured on a bicycle ergometer increased by 40%. It is concluded that SCS is vary promising in severe limb ischemia where reconstruction surgery is not possible or has been unsuccessful.
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Minerva anestesiologica · Jul 1992
Case Reports[Anesthesia of the brain stem after a retrobulbar block. Description of 2 cases].
The Authors report two cases of central nervous system complications after retrobulbar block. These complications have a 0.044% incidence in 4500 subsequent cases of retrobulbar blockade studied from 1981 to 1990. The Authors attribute the respiratory arrest and coma to direct access of the anesthetic to the central nervous system along the subdural space in the optic nerve sheath.
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Minerva anestesiologica · Apr 1992
Comparative Study[Tracheal intubation: increase of arterial pressure and cerebral blood flow velocity. Effect of thiopentone and propofol].
Induction of anaesthesia in intracranial surgery, especially for vascular diseases, must minimize haemodynamic changes: blood pressure and cerebral blood flow must not be increased to a high degree. Our work compares increases in blood pressure and in the speed of cerebral blood flow during endotracheal intubation in two groups of patients, who received propofol or thiopentone for the induction of anaesthesia. ⋯ Increase in blood pressure after intubation was lower with propofol than with thiopentone in a statistically significant way. Also the increase in the speed of cerebral blood flow, measured with doppler technique, was lower when induction with propofol was used, though not statistically relevant.
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One hundred and thirty three patients of both sexes were operated on for pituitary tumors with transphenoidal microsurgery. Postoperative complications are discussed.