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. METHODS:The incidence of clinical hypotension (systolic arterial blood pressure decrease by 30% or more from baseline), and bradycardia (heart rate < 50 beats/min) and other side effects have been evaluated in 1200 consecutive patients receiving integrated epidural/general anaesthesia. The time from induction of epidural anaesthesia to induction of general anaesthesia was considered as preoperative; while the time after general anaesthesia induction was considered as intraoperative. RESULTS:Preoperatively hypotension developed in 85 patients (2.8%), and bradycardia in 54 patients (4.5%). Intraoperatively, hypotension was observed in 380 patients (31.6%), and bradycardia in 153 patients (12.7%). Hypotension and bradycardia were not influenced by the type of surgical procedure, the type of maintenance of general anaesthesia (inhalational versus total intravenous general anaesthesia) and the level of epidural block (lumbar versus thoracic); but they were more frequent in patients with ASA physical status II and III-IV compared to patients with ASA physical status I (p < 0.05). Prophylactic volume preload decreased the incidence of hypotension from 41.5% to 22.4% (p < 0.0001), while prophylactic atropine before epidural block did not affect the incidence of bradycardia. Patients receiving epidural clonidine showed an increased incidence of intraoperative bradycardia compared to those who did not receive it (p < 0.0001). DISCUSSION:Randomized, controlled studies should be advocated in order to compare the incidence of hypotension and bradycardia during integrated anaesthesia and during epidural block alone. Our results demonstrated that the use of integrated epidural/general anaesthesia produces an incidence of perioperative hypotension and bradycardia similar to that reported when central blocks are used alone.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Fanelli G,Casati A,Berti M,Rossignoli Lsubject
Has Abstractpub_date
1998-07-01 00:00:00pages
313-9issue
7-8eissn
0375-9393issn
1827-1596journal_volume
64pub_type
临床试验,杂志文章,随机对照试验abstract:AIM:Pain resulting from nerve lesions is classically referred to as a ''burning pain''. Both the axonal damage and sensitization of unmyelinated C-fibres have been considered as the possible generators of this sensation. The aim of this study was to verify the hypothesis that hot-burning sensations are produced by the ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. The aim of this study was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anesthesia. METHODS:A prospective...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12720-9
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS:Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu Univers...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.16.11451-8
更新日期:2017-01-01 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:BACKGROUND:The goal of this paper was to investigate the association between patterns of intracranial hypertension (IH) and outcomes, to describe the treatment of patients with different patterns of IH, and to examine whether IH is an independent predictor of mortality and unfavourable outcome, respectively. METHODS:A...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an effective rescue therapy for improving oxygenation in selected severe acute respiratory distress syndrome (ARDS). Prone position (PP) is usually considered before vvECMO and few data are available on the association of PP during VV-ECMO. Thus, w...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract::Transthoracic thermodilution (TTT) measures cardiac output without the need for right heart catheterization. In addition, two volumetric hemodynamic indices have been derived from the mathematical analysis of the TTT curve: the global end diastolic volume (a quantitative measure of cardiac preload) and the extravascul...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract::A 74-year-old patient was submitted to urgent surgery for intestinal occlusion. After the induction of the anaesthesia, tracheal intubation failed since no progression of Eshmann tracheal tube introducer was possible. The ventilation was difficult and a laryngeal mask was inserted. After oxygenation, the tracheal tube...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-02-01 00:00:00
abstract::The successful management of 2 cases of rare myopathies, who underwent hemithyroidectomy, is here reported. Anaesthesia was induced with TPS and fentanyl, and maintained with isoflurane. Neuromuscular blockade was achieved by atracurium; neuromuscular monitoring by Neurostar-Medeleck was performed. This intraoperative...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVE:Weaning from mechanical ventilation is often possible in the most of patients, even if sometimes it is very difficult. For example, 25-53% of COPD patients cannot be weaned. The different modalities used do not justify this. The aim of the study was the evaluation of a further weaning trial in tracheotomized ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::Recently inhaled nitric oxide (iNO) has been used as pulmonary vasodilator without any effect on systemic hemodynamics. iNO has been also used in cardiac and thoracic surgery, involving lung transplantation. In this case report a patient, 41 years old female, affected by bronchiectasis, underwent bilateral sequential ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The efficacy of an ultrasound guided transmuscular quadratus lumborum block (QLB) for perioperative analgesia of the upper and lower abdomen remain debatable. The purpose of this study was to compare the cutaneous sensory blocked area (CSBA) between QLB blocks performed at the L2 vs. L4 levels. METHODS:Twen...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.19.13656-5
更新日期:2019-12-01 00:00:00
abstract::Regional anaesthesia is useful in day surgery when properly applied. Most commonly used techniques are IVRA, axillary block, local/infiltration plus monitored anaesthesia care. Spinal anaesthesia is also frequently used in DS. Depending on the technique used RA may fasten or prolong discharge when compared to general ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 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:BACKGROUND:Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia. METHODS:Fift...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.18.12291-7
更新日期:2018-11-01 00:00:00
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...
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:2003-12-01 00:00:00
abstract:AIM:The aim of our study was to compare the efficacy of hyperbaric and isobaric solutions of intrathecal levobupivacaine for transurethral endoscopic surgery. METHODS:Urological patients who were scheduled for elective surgery under spinal anesthesia were enrolled. The heavy group received 13.5 mg of hyperbaric levobu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Predictive models of acute kidney injury after cardiac surgery (CS-AKI) include emergency surgery and patients with hemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the cas...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:10.23736/S0375-9393.18.12257-7
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Recent meta-analyses failed to support the reliability of ultrasound assessment of the inferior vena cava (IVC) to predict fluid responsiveness. However, the techniques utilized were heterogeneous. We hypothesized that the variability of the elliptic section and caliber of the IVC along its course may influe...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.13041-0
更新日期:2019-05-01 00:00:00
abstract::Systemic air embolisms are a rare but often a fatal complication of endoscopic retrograde cholangiopancreatography (ERCP). Only few cases have been reported in scientific studies. This paper concerns a case of a systemic air embolism that occurred during endoscopic sphincterotomy for gallstone removal in a 79-year-old...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:The partial pressure of carbon dioxide (pCO2) gap is the difference between pCO2 values in the arterial and mixed venous blood; values higher than six mmHg may be predictive of tissue hypoperfusion. It is still doubtful if central venous blood can be used to assess the gap. This study was aimed to compare th...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13554-7
更新日期:2019-12-01 00:00:00
abstract::Pulmonary tuberculosis can lead to acute respiratory distress syndrome (ARDS) which is associated with high mortality. We report the case of a patient with pulmonary tuberculosis and severe ARDS (PaO2/FiO2<100 mmHg) who was initially managed with advanced up-to-date treatments (protective ventilation and extracorporea...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-03-01 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:Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS:To describe the incidence and consequences of serious RU complications resulting in length of stay > 4 days or 30-da...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-03-30 00:00:00
abstract:BACKGROUND:The use of second generation supraglottic airway devices is recommended for airway rescue in failed tracheal intubation. This study was performed to compare the clinical performance of the i-gel™ with that of the AuraGain™ in patients with simulated cervical immobilization. METHODS:We conducted a prospectiv...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14237-8
更新日期:2020-07-01 00:00:00
abstract::Tonomitor NG tube was positioned in the stomach of 11 critical ill patients during their stay in ICU and 48 measurements of intramucosal pH (pHi) have been performed. In 7 patients haemodynamic measurement were performed in concomitance with each pHi measure. The Authors looked for statistical relations between pHi an...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:The characteristics of sevoflurane make it able to be used without N2O avoiding its undesirable effects to this associates. The aim of the study is to evaluate the clinical characteristics of sevoflurane anesthesia "N2O free" in comparison to sevoflurane anesthesia with N2O. METHODS:920 patient undergoing e...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Gastric residual volume in ventilated critically ill may complicate gut function. Over the years studies suggested to tolerate progressively higher residuals. The relationship between such volumes and the development of ventilator-associated pneumonia (VAP) is still under debate. No reports deal with the rel...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-04-01 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:OBJECTIVE:To assess and record the response to continuous infusion of the phosphodiesterase inhibitor enoximone during weaning from mechanical circulatory support (MCS) and to verify the possibility of success with this indication in pediatric patients. DESIGN:Retrospective study. SETTING:Pediatric cardiac surgery in...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-01-01 00:00:00