Minerva anestesiologica
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The increased use of soda lime for low flow anaesthesia leads to some problems related to the interaction with halogenated agents. These agents may be absorbed by soda lime or degradated according to their water content. Halothane and enflurane, in contact with soda lime, produce some metabolites, but their concentration is low when compared to their own lethal concentration. ⋯ Some case reports of unexpected high carboxyhemoglobin levels during anaesthesia indicate the possibility of CO production from soda lime and baralyme when halogenated agents are used. This reaction occurs only with anaesthetics containing CHF2-moiety (isoflurane, enflurane and desflurane) and when some specific factors make soda lime or baralyme completely dry. Low flow anaesthesia preserves the moisture content of the soda lime and protects from carbon monoxide production, by increasing water content in the circle.
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Minerva anestesiologica · Apr 1997
Randomized Controlled Trial Clinical TrialSpinal anesthesia with clonidine and bupivacaine in young humans: interactions and effects on the cardiovascular system.
Clonidine, an alpha 2 agonist, is known to prolong the action of local anesthetics, and to provide a satisfactory analgesia; hypotension and bradycardia have been observed after its intrathecal administration. The aim of our study was to determine whether intrathecal administration of clonidine can reduce the dose of local anesthetic, and the effects of clonidine on the cardiovascular system, and on arousal level. ⋯ In summary, the addition of clonidine to hyperbaric bupivacaine seems to be particularly useful in unilateral spinal anesthesia, exerting minimal influence on haemodynamic parameters, and guaranting a satisfactory postoperative analgesia.
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Minerva anestesiologica · Mar 1997
Clinical Trial[Evaluation of cerebral perfusion during aortic clamping and cross-clamping in patients undergoing resection for abdominal aortic aneurysm. A study with transcranial doppler].
To evaluate the cerebral blood flow parameters assessed by transcranial Doppler during aortic cross-clamping and unclamping in patients undergoing abdominal aortic aneurysmectomy. ⋯ The Vm decrease at aortic unclamping might correlate with the acute changes in MAP (blood steal hypovolemia) and is likely due to an inadequate cerebral autoregulatory response to abrupt MAP changes. The arterial CO2 increase after aortic unclamping could lead to a dilation of cerebral arterioles and a rise of CBF (increase of Vm and decrease of PI). Transcranial Doppler is a simple and reliable technique for the monitoring of cerebral blood flow parameters and seems to be quite suitable for the recognition and the quantification of changes in these parameters induced by surgical manoeuvres able to produce hemodynamic instability.
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Minerva anestesiologica · Mar 1997
Guideline[IRC (Italian Resuscitation Council). Recommendations for training in basic life support (BLS)].
This report, drawn up by the BLS Committee of the IRC, gives the guidelines for BLS training, according to the conclusions of the Consensus Conference (CPCR Methodology Consensus Meeting: BLS and training) held in Monte Conero, Sirolo (Ancona) on June 24th, 1994. American Heart Association and European Resuscitation Council guidelines, published in 1992, were considered for reference. This document aims to achieve two purposes: to promote standardization in teaching and performing BLS techniques and to outline the minimum features of an effective BLS program.
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Minerva anestesiologica · Jan 1997
Randomized Controlled Trial Clinical Trial[Anesthesia with sevoflurane vs propofol in elective extracavity surgery].
To compare the cardiovascular effects and recovery characteristics of sevoflurane and propofol anesthesia in 80 ASA I and II patients undergoing elective extracavity surgery expected to last at least one hour. ⋯ In the sevoflurane group, heart rate and diastolic pressure were slightly higher than in the propofol group. Recovery time was faster after sevoflurane anesthesia.