Minerva anestesiologica
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Minerva anestesiologica · Apr 1994
Case Reports[Intracardial knotting of a Swan-Ganz catheter. Description of a clinical case].
A 79 year old female was admitted to CTO Intensive Care Unit in the immediate postoperative period of orthopedic surgery. A Swan-Ganz fiber optic catheter was inserted through the right internal jugular vein but it was not possible to obtain a satisfactory tracing off pulmonary artery occlusion pressure. ⋯ It was possible to extract the knotted catheter through original venotomy so avoiding surgery. We want to emphasize that it is of fundamental importance in the insertion of the Swan-Ganz catheter to respect the recommended distances and to avoid repeated attempts to advance and withdraw the catheter.
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Minerva anestesiologica · Mar 1994
Comparative Study Clinical Trial Controlled Clinical Trial[Respiratory exchange during laparoscopic and laparotomic cholecystectomy].
The utility of laparoscopic cholecystectomy in reducing postoperative pain and patient's hospital discharge is already known. Nevertheless peritoneal gas insufflation required by surgical procedure can modify respiratory homeostasis during general anesthesia. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy on pulmonary dead spaces and alveolar gas exchange during inhalation anesthesia compared with traditional laparotomic cholecystectomy. ⋯ VDphy/VT, VDalv/VT, P(a-Et)CO2 and A-aDO2 increased significantly in the CL-S compared to the CL-T group (p < 0.05). No differences were found in the VDan/VT. These results can be explained by analteration of the ventilation to perfusion ratio (VA/Q) with an increase of high VA/Q regions due to the antitrendelenburg positioning with a redistribution of blood flow towards basal zones.(ABSTRACT TRUNCATED AT 250 WORDS)
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Minerva anestesiologica · Mar 1994
[Sciatic and femoral nerve block with electro-neural stimulator (ENS) in surgery of the knee in day-care surgery].
This study was designed to evaluate locoregional anesthesia (double block of sciatic and femoral nerves with ENS) for ambulatory knee arthroscopic surgery. A statistical evaluation was performed in 50 adult outpatients (41 males, 9 females, ASA class 1 or 2) undergoing ambulatory knee arthroscopic procedures. Basal and intraoperative BP, HR SaO2 were recorded and the intensity of analgesia was also assessed according to the patient's subjective evaluation. ⋯ The effectiveness of the anaesthetic block was classified as very good in 84% of patients, good in 2%, sufficient in 6% and inadequate in 8%. All patients were discharged in four hours after surgery. Our study shows that in ambulatory arthroscopic surgery, sciatic and femoral block with ENS is a valuable alternative to general anaesthesia.
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Minerva anestesiologica · Mar 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Trazodone versus flunitrazepam in premedication in day-care surgery].
A prospective single-blind study was conducted to compare flunitrazepam vs trazodone in the premedication of patients undergoing day-case surgery for termination of pregnancy, with particular regard to the degree of preoperative sedation, intraoperative analgesia and postoperative recovery. 86 patients were randomly allocated to receive orally 45 minutes before the surgical procedure either flunitrazepam 2 mg (group F) or trazodone 50 mg (group T). In both groups anaesthesia was achieved by i.v. fentanyl 2.5 micrograms/kg and ketamina 250 micrograms/kg. Patients in group F showed a deeper degree of preoperative sedation. ⋯ In the postoperative period, the incidences of emetic symptoms and dizziness were similar in both groups; the incidence of drowsiness was significantly higher in group F at 120 minutes but not at 180 minutes of observation. Psychomotor performance was assessed preoperatively two days before the surgical procedure and 60, 120 and 180 minutes after surgery, using the Toulouse-Pieron test and the reaction time to a luminous stimulus with the aid of a computerized analogic tachystoscope (Neurometer). Trazodone allowed a more rapid recovery of psychomotor performance and it can represent a valid alternative to the use of benzodiazepines in the premedication of day-case surgical patients.