Minerva anestesiologica
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We studied 22 patients undergoing total intravenous anaesthesia for both abdominal and superficial surgery. Anaesthesia has been induced and maintained with propofol (1 mg/kg in 20 seconds; 10 mg/kg/h for 10 minutes; 8 mg/kg/h for 10 minutes; 6 mg/kg/h until the end of the operation) and alfentanil (15 mg/kg before the induction and boli of 10-30 mg/kg in the presence of insufficient surgical analgesia). ⋯ We observed: 1) haemodynamic stability after the intubation and during surgery; 2) easy control of surgical analgesia; 3) early postoperative recovery, with no correlation with the doses of propofol and alfentanil; 4) absence of postoperative respiratory depression; 5) intraoperative amnesia; 6) low incidence of postoperative side effects. We conclude that, by virtue of the pharmacokinetic characteristics of propofol and alfentanil, most limitations of total intravenous anaesthesia have been overcome.
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Minerva anestesiologica · Jan 1992
[How many interscalene blocks are there? Reflections on 109 cases studied with various techniques].
The effects of interscalene block were studied on 109 patients undergoing upper extremity elective orthopaedic surgery. Blocks were performed in a non-randomized manner with three different techniques, the site where anaesthetic solution was injected being the main distinguishing mark. The anaesthetic solution was injected into the interscalenic compartment both in the case of patients where classic technique had been carried out and in the group where the nerve stimulator had been used. ⋯ When the block was performed within the interscalenic compartment, the analgesic cover was usually restricted to the area supplied by the primary superior trunk of the brachial plexus. The different results were explained by the presence of fibrous sheaths within the interscalenic compartment limiting spread of the anaesthetic, which are absent close to the vertebral column. Therefore two types of interscalene block were postulated: an intrascalene or troncular block within the interscalenic compartment and a radicular or paravertebral block close the vertebral column.
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Minerva anestesiologica · Dec 1991
[Method for the analysis of changes in mixed venous oxygen saturation in vascular surgery].
Continues monitoring of SvO2 was carried aut using an Oxi metrix pulmonary arthery catheter in 12 patients undergoing aortic surgery. Hemodynamic measurements were made before skin incision (baseline values), before aortic cross clamping, after aortic declamping and postoperatively during shivering. ⋯ As DO2 and VO2 were correlate after measuring cardiac output from the same technique, a mathematical correction of a common error for linear calculations was applied. It was also concluded that changes of SvO2 greater than 10% of baseline values should prompt the assessment of hemoglobin, cardiac output, SaO2 and oxygen demand, but changes of SvO2 less than 10% of baseline value should not prompt measurements.