Abstract:
OBJECTIVE:To evaluate the cerebral blood flow parameters assessed by transcranial Doppler during aortic cross-clamping and unclamping in patients undergoing abdominal aortic aneurysmectomy. METHODS:Invasive intraoperative monitoring of mean arterial pressure (MAP) and PaCO2, and right middle cerebral artery (RMCA) monitoring of blood flow parameters (mean velocity "Vm" and pulsatility index "PI") by transcranial Doppler were performed as well as evaluation of the four parameters during these subsequent periods: pre-cross-clamping, pre-unclamping, unclamping and 1-5-10-20 minutes after abdominal aortic unclamping. RESULTS:No significative changes of MAP, PaCO2, Vm and PI were noticed during the aortic cross-clamping period (77.5 +/- 18.5 SD minutes). During aortic unclamping Vm and MAP decreased (64 +/- 20 vs 52 +/- 20 cm/sec, p < 0.05, and 101 +/- 8 vs 80 +/- 15 mmHg, p < 0.01, respectively). At the 1th post-unclamping minute there was an increase from pre-unclamping values of Vm (75 +/- 20 cm/sec, p < 0.05) and PaCO2 (42 +/- 1.5 vs 36 +/- 2 mmHg, p < 0.05), with persistent reduction of MAP (92 +/- mmHg, p < 0.05), even more evident at the 5th post-unclamping minute (Vm = 93 +/- 25 cm/sec; PaCO2 = 46 +/- 1.2 mmHg, p < 0.001, and MAP returned to pre-unclamping value), in which there was also a decrease of PI (0.65 +/- 0.16 vs 0.78 +/- 0.2, p < 0.05). At the 10th minute Vm (83 +/- 24 cm/sec, p < 0.02) and PaCO2 (41 +/- 1.5 mmHg, p < 0.05) increments were present together with persistent reduction of PI (0.69 +/- 0.17, p < 0.05), while at the 20th post-unclamping minute also Vm, PaCO2 and PI returned to their pre-unclamping values. CONCLUSIONS:The Vm decrease at aortic unclamping might correlate with the acute changes in MAP (blood steal hypovolemia) and is likely due to an inadequate cerebral autoregulatory response to abrupt MAP changes. The arterial CO2 increase after aortic unclamping could lead to a dilation of cerebral arterioles and a rise of CBF (increase of Vm and decrease of PI). Transcranial Doppler is a simple and reliable technique for the monitoring of cerebral blood flow parameters and seems to be quite suitable for the recognition and the quantification of changes in these parameters induced by surgical manoeuvres able to produce hemodynamic instability.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Pittella G,Benanti CF,Palombo C,Kozàkovà M,Distante A,Giunta Fsubject
Has Abstractpub_date
1997-03-01 00:00:00pages
69-75issue
3eissn
0375-9393issn
1827-1596journal_volume
63pub_type
临床试验,杂志文章abstract::A brief account of the physiopathology and clinical treatment of antigen-antibody reactions is followed by the description of a personal technique used for over 20 years in the detection of drug allergy. The method consists of a skin test followed by administration of increasing doses of the drug under examination. At...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::AIM. To evaluate the validity of general anesthesia using the laryngeal mask airway (LMA) in pediatrics in a series of 163 patients. MONITORING. ETCO2 and SpO2 were evaluated five minutes after the insertion of LMA and then at five minute intervals. SpO2 was evaluated every two minutes after the removal of LMA. Use of...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:AIM:Transcatheter aortic valve implantation (TAVI) is an emergent alternative technique to surgery in high-risk patients with aortic stenosis. Here, we describe the anesthesiological management of patients undergoing TAVI at our institution over an 18-month period. METHODS:After a proper assessment of surgical risk an...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2010-02-01 00:00:00
abstract::Neuroleptic malignant syndrome (NMS) in its most severe form ranging from disorders of consciousness to coma is now reported relatively frequently in intensive care journals. Having observed such a case in the intensive care ward of their hospital, the Authors investigate the possibility of differential diagnosis betw...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::A randomized, multicenter trial conducted in 32 northern European general intensive care units (ICUs) enrolled some patients with septic shock randomly assigned to receive a red blood cell transfusion when the hemoglobin (Hb) level was ≤7 g/dL ("lower threshold"; N.=502) or ≤9 g/dL ("higher threshold"; N.=496) through...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-09-01 00:00:00
abstract::The authors report the results of two clinical studies on postoperative pain relief with PCA. In the first clinical study 44 patients, undergoing gynecologic surgery, were assigned at random to two groups. The first was treated by PCA (infusor Baxter) with morphine i.v. (basal bolus 0.05 mg/kg, loading doses 1 mg ever...
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:1993-10-01 00:00:00
abstract:INTRODUCTION:Ultrasound is a portable and safe technology that is increasingly used to assist anesthetic procedures and has been integrated into the routine practice of a wide range of invasive procedures. As a complementary diagnostic tool, publications related to perioperative support other than vascular access and n...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.17.12178-4
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Anaesthesia drugs cause the cutaneous vasodilatation that produces core temperature lowering at the beginning of general anaesthesia; when the thermal threshold for vasoconstriction is reached the cutaneous heat losses are decreased. Furthermore, the soda lime begins to produce water and heat after 40 minute...
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:1995-09-01 00:00:00
abstract::Clinical neurophysiology is both an extension of clinical examination and an integration of neuroimaging. It plays a role in diagnosis, prognosis and monitoring in the Intensive Care Unit (ICU). Electroencephalography (EEG) and somatosensory evoked potentials (SEPs) are the most informative neurophysiological tests. B...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2012-09-01 00:00:00
abstract::The purpose of the case is to report the clinical value of the ultrasound-guided posterior approach to the brachial plexus in the treatment of phantom limb syndrome after an upper extremity amputation. The author experienced ultrasound guidance as sole technique to localize the brachial plexus for the purpose of placi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::The overall use of allogeneic blood transfusions in clinical practice remains relatively high and still varies widely among centres and practitioners. Moreover, allogeneic blood transfusions have historically been linked with risks and complications: some of them (e.g. transfusion reactions and transmission of pathoge...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-10-01 00:00:00
abstract::A multimodal, rehabilitative, fast discharge approach to abdominal aortic surgery is analyzed. The approach was developed in two phases during the years 1997-2000: in the first phase (1997) patients had thoracic epidural anesthesia plus TIVA and analgesia. They had improvement of the classical surrogate outcomes and a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:A short hospital stay is nowadays desirable and affordable for a wide range of surgical pathology, respecting safety of care and home discharge. In the present study, the Authors investigated the use of TIVA with propofol/remifentanil during microsurgical vertebral disc resection to maintain a controlled vas...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and ass...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To evaluate efficacy and tolerability of enoximone, a phosphodiesterase inhibitor, in the treatment of cardiogenic shock. DESIGN:A prospective non randomized, non comparative study. SETTING:A general intensive care unit of a university hospital. PATIENTS:Six patients with cardiogenic shock (cardiac index <...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:Inhaled NO can improve arterial oxygenation in ARDS. We evaluated the incidence and the magnitude of this effect during a short test of NO inhalation. This was performed in 24 consecutive mechanically ventilated patients with ARDS in order to assess the interest of NO for the therapy of hypoxemia in each case...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::The selection of opioid drugs for anesthesia is often based on empirical judgment such as the selection of opioids with rapid elimination half-life for short surgical procedures (e.g. alfentanil), while opioids with longer elimination half-life (e.g. fentanyl, sufentanil) are used for longer procedures. A better insig...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2000-05-01 00:00:00
abstract:AIM:The authors have evaluated remifentanil for intraoperative analgesia in endonasal endoscopic surgery for pituitary lesions. METHODS: EXPERIMENTAL DESIGN:a perspective, randomized and comparative study between remifentanil and fentanyl for intraoperative analgesia was performed in an operating room of the neurosur...
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:2003-03-01 00:00:00
abstract::The use of epinephrine is currently recommended as a treatment option for patients with cardiac arrest. The primary objective of this systematic review was to determine if epinephrine use during cardiac arrest is associated with improved survival to hospital discharge. MEDLINE, EMBASE, The Cochrane Library (Cochrane D...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2014-07-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract::Sepsis is a condition at high risk for the patients to develop organ(s) or system dysfunction/failure and represent a very limiting process for survival. Researchers and clinicians proposed standardization of terminology for sepsis and related problems to improve communication and to evaluate the efficacy of preventiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-07-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 信件
doi:10.23736/S0375-9393.18.13167-1
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-06-01 00:00:00
abstract::Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus pl...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Coronary artery bypass graft surgery with cardiopulmonary bypass induces a systemic inflammatory response. However, when thoracic epidural anaesthesia is administered as part of a combined anesthetic technique, the stress response associated with the cardiopulmonary bypass (CPB) may be attenuated. METHODS:T...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2008-11-01 00:00:00
abstract::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 laparos...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::The improvement in the success of solid organ transplantation over the past decades is remarkable and well documented. It is now a well-accepted treatment modality for patients with end-stage organ disease. Within the field of transplantation, abdominal organ transplantation is significantly more common than thoracic ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-04-01 00:00:00
abstract::A new type of 10% lipidic emulsion based on safflower oil and soya (Liposyn II, Abbott, Latina) characterised by a high linoleic/linolenic acid ratio was administered in random, double blind fashion with 10% Intralipid to 20 subjects submitted to major surgery of the digestive system. Dosage was 1.2 g/kg at an infusio...
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:1989-01-01 00:00:00
abstract::In severe sepsis, several studies, a recent meta--analysis and studies evaluating multifaceted strategies for quality improvement, have shown that bundled care can improve survival. Here, the effectiveness of treatments for severe sepsis included in the bundles was analyzed. Despite the observational design of the stu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-03-01 00:00:00