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A M Melani

Publications and source records attributed to A M Melani.

6 recordsLinked to original sources

[Light-guided intubation using Trachlight].

BACKGROUND: A new intubating transilluminated device (Trachlight) has been recently proposed as an alternative to tracheal intubation with direct laryngoscopy. OBJECTIVE: 1) To evaluate Trachlight device in orotracheal intubation and to assess its operation and complications. 2) To compare the time consumption of transillumination intubation in respect to direct laryngoscopy on the same patients. METHODS: The first study was performed on 50 patients undergoing elective surgery and submitted to Trachlight intubation alone; speed of intubation, number of attempts and all complications were recorded and related to Mallampati classes. In the second study 16 patients undergoing to elective surgery were enrolled. Each patient was classified according to both the Mallampati classes and the Cormack classes. Each patient was submitted to two tracheal intubations: the first with the Trachlight and the second with conventional direct laryngoscopy performed by the same anesthesiologist. The time to intubation and the number of attempts were recorded and related to the Mallampati and Cormack classes. RESULTS: In the first study time of intubation with Trachlight was 20.93 +/- 13.02s (mean +/- SD) without statistical differences in respect to the Mallampati classes. In the second study the times to intubation were without any statistical difference independently of the technique of intubation and of the Mallampati or Cormack classes. CONCLUSIONS: Orotracheal intubation using Trachlight appears to be an effective and easy to learn technique, being also easy, safe and fast to carry out. The comparison with direct laryngoscopy showed the same speed and effectiveness even on patients with difficult intubation.

Adolescent

[Quality of care at a regional emergency medical system].

The Emergency Medical System (EMS) in the district of Florence is based upon the activity of 13 Emergency Mobile Unit (EMU). The activity of such a huge system is difficult to evaluate: we have concentrated our attention upon the diagnostic process assuming that "correct diagnosis = correct treatment = benefit for the patient". Then we compared diagnoses set on EMU to diagnoses made in hospitals, giving to each comparison a score from 1 to 5. In terms of quality the services of the EMS in Florence seem to be effective, since in 72% of cases the Hospital Emergency Department has confirmed the diagnoses achieved under emergency conditions, and in 12% only there has been remarkable difference. Comparing the diagnoses made on EMU to that at the hospital discharge, in two thirds of cases there is excellent correlation.

Ambulances

[Anesthesia with sevoflurane vs propofol in elective extracavity surgery].

OBJECTIVE: To compare the cardiovascular effects and recovery characteristics of sevoflurane and propofol anesthesia in 80 ASA I and II patients undergoing elective extracavity surgery expected to last at least one hour. DESIGN: A prospective randomized clinical trial. METHODS: After meperidine and atropine premedication, the patients were randomly allocated into two groups: in the sevoflurane group thiopentone was administered for induction of anesthesia and sevoflurane for maintenance; the propofol group received propofol either for induction of anesthesia or maintenance. All patients received N2O, vecuronium, artificial ventilation and fentanyl as needed. Vital parameters were monitored during anesthesia and two hours later. Recovery times were recorded after anesthesia. Statistical analysis was performed with SAS (Statistical Analysis System). RESULTS: In the sevoflurane group, heart rate and diastolic pressure were slightly higher than in the propofol group. Recovery time was faster after sevoflurane anesthesia.

Adolescent