Minerva anestesiologica
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Minerva anestesiologica · Mar 1999
Review[Subarachnoid hemorrhage and systemic arterial pressure. Physiopathology and perioperative management].
A correct assessment of arterial pressure state during subarachnoid haemorrhage (SAH) is one of most critical issue in neurologic intensive care and in neuroanesthesia. It is important to evaluate two different clinical conditions during SAH: before and after aneurysmal clipping or embolization. ⋯ In this review the Authors examine the pathophysiology of SAH and SAH complications as rebleeding, vasospasm and ischemia. According to international data, they propose pressure parameters appropriated for SAH according to timing of treatment so as to prevent and treat SAH complications.
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Minerva anestesiologica · Jan 1999
Review[Preemptive analgesia or balanced periemptive analgesia?].
"Preemptive analgesia" means that analgesia given before the painful stimulus prevents or reduces subsequent pain. The concept of preemptive analgesia originates from basic science and experimental studies. However, in some clinical studies preemptive effect is not always present. ⋯ Postoperative pain can be reduced making a pharmacological treatment before surgery, for the whole time of painful stimulus. For this reason, the term "preemptive analgesia", like "analgesia given before surgery" is not adequate. The authors suggest that the concept of prevention of postoperative pain is well defined by the term of "balanced periemptive analgesia"; it is a new approach that use many modalities of analgesia in different times to prevent and control painful stimulus for the whole time of its origin: before and/or during operation and, if necessary, in the postoperative period for the residual pain.