Minerva anestesiologica
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Hypertrophic pyloric stenosis is one of the most common gastrointestinal abnormalities occurring in the first six months of life. It is a medical emergency and surgical therapy is considered only after correction of fluid and electrolyte deficits. Careful preoperative therapy to correct deficits may require several days to ensure safe general anaesthesia and surgery. ⋯ General anaesthesia was performed without complications. All patients were discharged during the period between the 2nd and 7th day after surgery, except one who was discharged after 16 days because of dehiscence of the surgical wall. Preoperative preparation is the primary factor contributing to the low perioperative complication rates, and the necessity to recognize fluid and electrolyte imbalance is the key for a successful anaesthetic management.
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Minerva anestesiologica · May 1995
Clinical Trial[Ultrasonography-guided identification of the lumbar epidural space].
The study was designed to assess the reliability of sonographic evaluation in the prediction of the depth of the lumbar epidural space. Forty males, scheduled for epidural anesthesia for surgical repair of inguinal hernia, were prospectively studied. Patients were placed in a sitting position and sagittal scanning of the lumbar spine was performed with a 5-MHz transducer over the fourth or fifth interspace in order to identify the deeper hyperechogen interface, which represents the landmark between the ligamentum flavum and the epidural space. ⋯ The potential for using ultrasounds for prediction of the distance from skin to epidural space was analyzed using a simple linear regression analysis; p values < 0.05 were considered significant. Mean values of ultrasound depth and needle depth were respectively 51 mm (SD 6.3) and 50.9 mm (SD 6.2); the correlation coefficient was 0.99. Ultrasound scanning of the lumbar spine provides an accurate measurement of the depth of the epidural space, which can facilitate the performance of the epidural anaesthesia and may decrease the complication rate, particularly in those patients in which anatomic landmarks are obscured.
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Minerva anestesiologica · May 1995
Comparative Study Clinical Trial Controlled Clinical Trial[Comparison of 2 modified Fick methods and thermodilution for determining the cardiac output in patients with mechanical ventilation].
To evaluate the effectiveness of two cardiac output measurement methods based on a modified Fick equation, that calculate the O2 consumption (VO2) dividing the CO2 production (VCO2) by a fixed respiratory quotient (RQ). ⋯ The correlation coefficients of the two modified Fick methods with COTD are good, and the mean differences between their results and the gold standard are small, but the low precision of both tested methods demonstrated by the very large limits of agreement, severely reduce the clinical reliability of the measurements. Only for the less than 7 L cardiac outputs the COFra limits of agreement with COTD are narrow enough, and in this range the technique can be useful e.g. revealing a low cardiac output.
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Minerva anestesiologica · Apr 1995
[Assessment of intensive therapy: 4-year experience using the Apache II severity score].
To determine the outcome of critically ill patients and to study the characteristics of the population admitted to the intensive care unit. ⋯ These findings suggest that Apache II score is able to investigate critical ill patients, to stratify patients into disease groups and to quantify correctly the overall risk of death but cannot be used in decision making or to govern admissions in intensive care unit.
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Minerva anestesiologica · Mar 1995
Clinical Trial[Effectiveness and modality of continuous infusion administration of atracurium dibesylate].
One-hundred and five patients with ASA I-II were scheduled for general surgery. Atracurium was the muscle-relaxant of choice. ⋯ The neuromuscolar function was investigated evaluating the amplitude of response to TOF and DBS. This procedure proved to be safe, reliable and easily performed in every operating room.