Minerva anestesiologica
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Minerva anestesiologica · Jul 1999
Case ReportsElectric nerve stimulation: analysis of two clinical cases of failed nerve electrolocation by using sheathed needles.
The aim of this work was to explain the reasons of two unsuccessful blocks of sciatic nerve even if anaesthetic solution was injected through insulated needle on elicited twitch. The clinical cases were two outpatients undergoing diagnostic arthroscopy of knee under anaesthetic block of sciatic and femoral nerves. In both patients, the muscular twitch appeared when the ischiatic bone was kept in unexpected touch with needle tip. ⋯ Referred events disagree with some experimental works performed out of clinical environment, which found that total amount of administered current through an insulated needle gathers always in front of the tip. Our clinical observations seems to confirm an electrolocation mistake called "electrical shadow". The ability of sheathed needles to work as occasional capacitor due to the alternation of two conductor layers (needle shaft and tissue) and of a dielectric (coating material) can explain some missing electrolocations, as the appearance of electric fields within dielectric needle sheathing.
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Minerva anestesiologica · Jul 1999
Case Reports[Use of the laryngeal mask for airway control in difficult intubations in children].
LMA was introduced in clinical practice by Arthur Brain in 1983 as a valuable substitute of tracheal tube in adult who underwent general anaesthesia; since then its applications have been extensively studied. LMA is a relatively new non-invasive ventilatory device which has allowed a radical change in the management of modern general anaesthesia. ⋯ In all these cases, LMA provided a patient airway and a satisfactory ventilation during both induction and the repeated attempts of inserting the tracheal tube; in one case, since the orotracheal intubation failed, LMA has proved to be as effective as the tracheal tube during the maintenance of general anaesthesia. Therefore, LMA is recommended as an essential ventilatory device in the hands of paediatric anaesthesiologists.
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Minerva anestesiologica · Jul 1999
Randomized Controlled Trial Comparative Study Clinical Trial[Percutaneous or surgical trachetomy. Prospective, randomized comparison of the incidence of early and late complications].
To compare early and late complications after either conventional surgical or percutaneous dilatational tracheostomy. ⋯ In experienced hands, percutaneous dilatational tracheostomy is as safe and effective as the conventional surgical tracheostomy. The percutaneous technique is less time-consuming and has a lower rate of early infectious complications with better cosmetic results than the surgical technique.
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Minerva anestesiologica · Jul 1999
Case Reports[NMR in the diagnosis and treatment of neurologic lesions in decompression sickness].
The case of a decompression sickness in woman, diving to 26 meter depth is reported. The patient was helped by instructor's computer (error!) and she presented risk factors for embolic disease (obesity, smoke, estroprogestinic therapy). ⋯ She was not treated on the place of incident, but only 36 hours later at our center of hyperbaric medicine. Her Magnetic Resonance imaging showed hyperintensity lesions of white matter.