Abstract:
AIM:The study compares the intraoperative effects of combined versus general anesthesia during major liver surgery. METHODS:In this prospective randomized study, 70 patients were divided into 2 group of 35 subjects. Group A received general anesthesia (thiopentone, fentanyl, vecuronium, sevoflurane in a closed circuit) 15 minutes after placement of an epidural catheter (D9-D10) and induction of epidural anesthesia (6 ml 2% naropine). Continuous epidural infusion was initiated before surgical incision and continued with 0.2% naropine (7 ml/h) until the end of the operation. Group B received combined intraoperative anesthesia wit fentanyl doses according to hemodynamic parameters and 0.1 mg/kg morphine 30-4 minutes before cutaneous suture. Hemodynamic values were measured at base line (T0), and then at 15, 30, 60, 120 and 180 minutes after induction of general anesthesia (T1, T2, T3, T4 and T5, respectively). On recovery, patients were assessed for pain at rest and on movement reported on a visual analog scale; degree of motor blockade according to the Bromage scale; appearance of side effects; use af analgesic. RESULTS:A statistically significant decrease in the mean arterial blood pressure (ABP) and heart rate (HR) was noted within each group at 15 minutes after induction of general anesthesia. Significant differences in ABP were found between the 2 groups at T1 to T5, whereas HR values were substantially similar. The mean intraoperative use of fentanyl was significantly higher in Group B than in Group A, as was that of vecuronium. Pain intensity on recovery in patients who received epidural anesthesia was lower both at rest and on movement; only the patients in Group B required additional analgesics. No motor blockade was observed in either group. Nausea and vomiting were more frequent in Group B; hypotension was more frequent in Group A. CONCLUSION:The study confirms the safety of locoregional anesthesia in liver surgery, with good hemodynamic stability and absence of major side effects. The lower intraoperative use of opioids and muscle relaxants in patients who received epidural anesthesia confirms the neurovegetative protection this method provides. The data support the hypothesis that greater intraoperative use of opioids may be responsible for the higher incidence of side effects. Therefore, the intraoperative use of combined low-concentration anesthetic agents alone appears to offer a reasonable treatment option that provides adequate pain control at recovery from general anesthesia, with only minor side effects typically associated with analgesic (motor blockade) and opioids (nausea and vomiting). Given the complications associated with the technique, it should be performed by an expert anesthetist.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Siniscalchi A,Begliomini B,Matteo G,De Pietri L,Pasetto Akeywords:
subject
Has Abstractpub_date
2003-12-01 00:00:00pages
885-95issue
12eissn
0375-9393issn
1827-1596journal_volume
69pub_type
临床试验,杂志文章,随机对照试验abstract:UNLABELLED:In last the 50 years many studies have described the causes of mortality. In newborns and infants between 5 and 6 months the risk is higher. The heart is not developed as in older/grown child and these infants need more oxygen than the older ones. Probably, the interaction or interference of positive pressur...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract::Fifteen to 30% of patients develop acute renal failure (ARF) following rhabdomyolysis and rhabdomyolysis accounts for 5 to 9% of all ARF. Experimental studies revealed two critical factors that predispose to myoglobinuric ARF: hypovolemia/dehydration and aciduria. At the nephron level, three basic mechanisms underlie ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The index E/e' derived from tissue Doppler imaging and pulsed Doppler is the ratio of the early transmitral flow velocity and the early mitral annular velocity and it correlates with left ventricular filling pressure. The purpose of this study was to investigate the relationship between intraoperative E/e' a...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:We prospectively evaluated the effect of insertion angle on the visibility of echogenic and nonechogenic needles in phantoms and in axillary nerve blocks in patients. METHODS:Conventional and echogenic needles were studied in phantoms at insertion angles of 0-30°, 30-45°, and ≥ 45°. Operators rated comfort ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the use of laryngeal mask airway (LMA)® Protector™ by comparison with traditional LMA for performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). METHODS:This was a retrospective observational single-center study including 143 patients w...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13328-7
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outco...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13307-X
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-07-01 00:00:00
abstract::The Authors report their clinical experience about the use of atracurium besylate in preventing succinylcholine-induced fasciculations and postoperative myalgias in fifty athletes (ASA class 1), submitted to arthroscopic meniscectomy. The patients were pretreated with atracurium 5 mg i.v. or saline solution in a doubl...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::In 8 patients who underwent abdominal surgery for non-neoplastic reasons, we have evaluated some parameters of renal function (PRP, NaU, GFR and diuresis) plasma levels of PRA and ADH and urinary prostaglandins PGE2 and 6-keto-PGF1 alpha. In 4 patients we found that surgery per se was associated with enhancements of P...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Mechanical ventilation may induce or aggravate lung injury, a phenomenon known as ventilator induced lung injury (VILI). On a macroscopic level, the effects of mechanical stress and strain on lung tissue are well described. Increased tidal volumes may lead to volutrauma, raised airway pressures may cause barotrauma an...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2014-08-01 00:00:00
abstract:INTRODUCTION AND AIMS:Thromboembolic disease can, in a large number of cases, be prevented in patients undergoing major surgery by using low molecular weight heparin (LMWH). These molecules extracted from standard heparin using a variety of cleavage methods possess different physical and chemical characteristics. The a...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:AIM:Microdialysis allows the biochemical analysis of interstitial fluids as a bedside procedure. This technique is of interest to evaluate the glucose dependent metabolism in hypoglycaemic patients. It was the aim to perform subcutaneous and blood microdialysis during hypoglycaemic clamp experiments in 12 healthy young...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:We hypothesized that the use of the channeled King Vision™ and Airtraq® would shorten the time for tracheal intubation compared with the Macintosh or GlideScope® laryngoscopes in patients with normal airways. METHODS:Eighty-six patients were randomly assigned to intubate the trachea using either the Macinto...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The goal of the present work is to describe the development and results of the pediatric epidural analgesia program at the ''Hospital Nacional de Pediatria Prof. Dr. J. P. Garrahan'' in Argentina. METHODS:Patients with thoracotomy, abdominal surgery, osteotomy, amputations or severe trauma were included in ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
abstract::Even moderate temperature elevations soon acute cerebral damage may markedly worsen initial brain injury. These effects may justify aggressive antipyretic treatment in neurosurgical intensive care unit (NICU). On the basis of a literature survey, it is observed that fever is extraordinarily common in the neurosurgical...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-04-01 00:00:00
abstract::Noninvasive positive pressure ventilation (NPPV) via nasal mask is well known to be effective in the treatment of acute respiratory failure (ARF) secondary to chronic obstructive pulmonary disease (COPD). A case of ARF with hypercapnic coma due to exacerbation of COPD is described. Six hours of conservative therapy wi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::Chronic musculoskeletal pain is a highly prevalent condition that is commonly encountered in both general and specialist practice. Nonetheless, it still represents a significant challenge to the practitioners because of the lack of substantial evidence-based guidance. This review aimed to summarize the main pathophysi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14573-5
更新日期:2020-12-01 00:00:00
abstract::The paper reports the case of a young male which was severely poisoned by anilyne shoe black. After a few hours, he was in a semicomatose state, accompanied by "very dark" arterial blood gases with oxygen tension in excess of 100 mmHg. Following the administration of intravenous methylene blue (2 mg/kg), methemoglobin...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:To evaluate the results of treatment of severe acute respiratory distress syndrome (ARDS) with extracorporeal life support (ECLS), minimal sedation and low pressure supported ventilation in adults. METHODS: DESIGN AND SETTING:observational study in a tertiary referral center, Intensive Care Unit, Astrid Li...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Sepsis is an important cause of mortality and morbidity in the intensive care unit (ICU). We performed a study to describe the epidemiology of sepsis syndromes in patients admitted to ICUs of the Piedmont region. METHODS:In this prospective, multicentre, observational study, all 3902 patients admitted to a ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:
更新日期:2013-09-01 00:00:00
abstract::Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-04-01 00:00:00
abstract::Two groups of 15 children aged from 15 days to 6 years, undergoing surgery on cardiopulmonary by-pass for congenital heart disease have been retrospectively analyzed. Group A received a low-dose aprotinin treatment (30,000 KIU/kg in the priming solution); group C (control group) did not receive any aprotinin. Groups w...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::This report takes into consideration the complications due to "body packers" cocaine absorption. In particular we report a clinical case in which severe dysrhythmias occurred. We think an early insertion of a pacemaker able to rid ectopic focus by overdriving is essential by comparison with an effective anti-dysrhythm...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract::Pulse-oximeter is described as the most important technological proceeding for monitoring the patients' safety during anesthesia, after surgery and in emergency. This opinion was widely confirmed in the 1990s when pulse-oximeter has been definitively introduced in the standard for base monitoring in the OR and has bee...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-05-01 00:00:00
abstract::The authors illustrate some relevant emerging topics in pediatric anesthesia. Endotracheal cuffed tubes have entered into routine clinical practice in younger patients. Concerns about tracheal stenosis were overcome when manufactures began to produce a new class of high volume, low pressure endotracheal tubes. Ultraso...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency become...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.17.11565-8
更新日期:2017-07-01 00:00:00
abstract:AIM:We evaluated the perioperative levels of plasma myoglobin (Mb) and creatine kinase (CK) in patients submitted to peripheral revascularization surgery for a variety of conditions. METHODS, DESIGN AND SETTING: Observational study in a surgical ward of a community hospital. subjects: 50 consecutive patients were inclu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2004-12-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 评论,信件
doi:10.23736/S0375-9393.19.13586-9
更新日期:2019-06-01 00:00:00
abstract::A case of pulmonary edema secondary to dislocation of laryngeal mask during awakening from anesthesia is described. The complication has been ascribed to physiopathological changes of the alveolo-capillary membrane caused by inspiratory efforts secondary to dislocation of laryngeal mask during awakening from anesthesi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:AIM:The aim of this study was to evaluate and compare the parameters for mechanical respiration in pediatric patients undergoing controlled ventilation with a laryngeal mask (LM) and an uncuffed orotracheal tube. METHODS:The study examined 100 ASA 1 patients undergoing general anesthesia with myoresolution and mechani...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00