Minerva anestesiologica
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Minerva anestesiologica · Mar 1996
Review[Experience of an intermediate respiratory intensive therapy in the treatment of prolonged weaning from mechanical ventilation].
109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, presented the following diseases: COLD (70%), cardiovascular (15%) and neuromuscular (15%). A relapse of underlying disease (62%), pneumonia (20%), thoraco-muscular pump failure (15%) and pulmonary embolism (3%) were the relapsing causes needing the ICU admission. ⋯ Maximal inspiratory pressure (31 +/- 7 cmH2O) and respiratory rate/tidal volume (83 +/- 34) were measured within 48 hours after RIIU admission. 82 subjects (75%) were weaned after 6 +/- 4 days of MV using in 87% of patients pressure support technique with spontaneous breathing cycles with oxygen supplementation. 8 patients on 109 (7%) died; 20 patients on 109 (18%) were discharged after 40 +/- 9 days of stay in RIIU necessitating home MV more than 18 hours/day by means of a tracheostomy. All patients stay in RIIU for 17 +/- 7 days with a mean cost per die of 750 thousands lire. Our data suggest that a RIIU institution for prolonged weaning in chronic diseases may be a useful solution to decrease superfluous stays in ICU decreasing costs without ba worsening in quality of care.
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Minerva anestesiologica · Jan 1996
Randomized Controlled Trial Comparative Study Clinical Trial[Spinal anesthesia in cesarean section: 1% versus 0.5% hyperbaric bupivacaine].
To compare the quality of anesthesia produced by the intrathecal administration of equivalent doses of 0.5% and 1% hyperbaric bupivacaine in patients undergoing cesarian section. ⋯ No important difference was observed in the quality of the anesthesia obtained using the intrathecal administration of equivalent doses of 1% and 0.5% solutions of hyperbaric bupivacaine in patients undergoing cesarian section. In view of the possible relationship between the neurotoxicity of local anesthetics and the concentration of the solution used for spinal anesthesia, it is to be hoped that less concentrated solutions of hyperbaric bupivacaine will be introduced in Italy compared to the 1% solution currently available.
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Minerva anestesiologica · Jan 1996
Clinical TrialPharmacokinetic profile of the induction dose of propofol in chronic renal failure patients undergoing renal transplantation.
To define the pharmacokinetic profile of the induction dose of propofol in chronic renal failure patients. ⋯ From the data gathered in this study, propofol can be considered a suitable anaesthetic agent for the induction of general anaesthesia in uraemic patients. In our opinion these data could constitute a basis for future protocols of total intravenous anaesthesia with propofol in uremic patients.
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AIM. To evaluate the validity of general anesthesia using the laryngeal mask airway (LMA) in pediatrics in a series of 163 patients. MONITORING. ⋯ Measurement of every complication during and after anesthesia. CONCLUSIONS. In pediatric anesthesia LMA represents a good link between anesthetic equipment and the patient.
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Minerva anestesiologica · Dec 1995
Comparative Study Clinical Trial Controlled Clinical Trial[Clinical pharmacology of pipecuronium; a comparative study of its duration of action in balanced anesthesia (propofol/fentanyl) vs isoflurane].
Clinical pharmacology of pipecuronium; a comparative study of its duration of action between balanced (propofol/fentanyl) and isoflurane anesthesia. Pipecuronium duration of action has been compared between patients under balanced (propofol/fentanyl) or 0.8-1 Mac isoflurane anesthesia. T1/TC 10-25-50-75-90% (T1/TC, 10, T1/TC, 25, T1/TC, 50 TOF, 75T1/TC 90) and TOF 10-25-50-75% (TOF 10%, TOF 25%, TOF 50%, TOF 75%) ratios were studied; T1/TC 10-75% (T1/TC 10/75) and TOF 10-75% (TOF 10-75%) recovery times were also derived. ⋯ The presence of isoflurane significantly prolonged recovery times (TOF 10%, from 55 to 70, TOF 25% from 61 to 88, TOF 50% from 75 to 120) in group I (cumulative doses) patients. Recovery times were dose related, while age did influence recovery only at the earlier intervals (T1/TC 10 and 25%). Keeping in mind the limited range of age and dosages, advantages and disadvantages of the drug are discussed, comparing the experimental results with those derived from the literature.