Biomedical subjects

A Pasetto

Publications and source records attributed to A Pasetto.

23 records · Page 2Linked to original sources

PubMed1994

The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study.

This randomized double-blind placebo-controlled study was designed to evaluate the effects on postoperative pain of the local anesthetic, 0.5% bupivacaine with epinephrine, sprayed hepatodiaphragmatically under the surgeon's direct view during laparoscopic cholecystectomy. Metabolic endocrine responses to surgery (glucose and cortisol) and nonsteroidal anti-inflammatory drug requirements were investigated, as well as the presence of nausea, vomiting, and sweating. Local anesthetics or placebo solutions were given as follows. Immediately following the creation of a pneumoperitoneum, surgeons sprayed the first 20 mL of solution (S1), and an additional 20 mL of solution (S2) was sprayed at the end of the operation. Patients were classified into three groups (14 patients per group). Group A received 20 mL of saline during both S1 and S2, group B received 20 mL of saline during S1 and 20 mL of bupivacaine during S2, and group C received 20 mL of bupivacaine during both S1 and S2. The degree of postoperative pain was assessed using the visual analogue scale (VAS) and the verbal rating scale (VRS) on arrival in the recovery room and subsequently at time intervals of 4 h, 8 h, 12 h, and 24 h. The results of this study indicate a significant decrease of postoperative pain in patients treated with local anesthetic. VAS and VRS pain scores, as well as respiratory rate and analgesic requirements, were significantly lower in group C. The postoperative plasma cortisol level in group C was significantly lower than in groups A and B.

Adult↗

PubMed1991

[Effectiveness of regional anesthesia for loco-regional carotid surgery. Retrospective review of 147 interventions].

The Authors present a retrospective review that compares general anesthesia with regional anesthesia performed during carotid endarterectomy surgery. The study includes 147 procedures, performed on 144 patients: 76 had general anesthesia and 71 had regional anesthesia. After emphasizing the importance of conscience preservation during regional anesthesia to allow a simple and secure monitoring of the patient's neurologic functions, the Authors point out the decrease of peri- and postoperative accidents, whether neurologic or not, obtained with regional anesthesia. Another essential advantage of this technique is the possibility to insert the transitory shunt only when objectively necessary, ulteriorly reducing neurologic complications. Cervical plexus block is primarily indicated for high risk patients with instable neurologic simptomatology, severe stenosis of the contralateral carotid, coronary heart disease. The technique has proved to be of easy execution, safe and well accepted by the patient and the surgeon.

Aged↗

PubMedDate not supplied

[The analgesic treatment of the surgical patient].

An effective treatment of postoperative pain can achieve a better postop course especially in high risk patients. Pain is unacceptable when it can be relieved and, beside all it causes vasoconstriction, hypertension, tachycardia, fluid retention and pulmonary hypoventilation. A correct use of both narcotic drugs and NSAIDs are sufficient in most cases. In high risk patients, mainly after thoracic and upper abdominal procedures, insertion of a peridural catheter for drug administration can be very useful. The authors discuss the therapeutic possibilities according mainly to their experience.

Analgesia↗

PubMedDate not supplied

[Effects of extracorporeal circulation and hypothermia on cellular immune activity in patients undergoing heart surgery].

Aspecific cellular reactivity was assessed in patients who underwent open heart surgery. The authors conclude that depressed PMN activity measured as O2- production is not linked to anaesthesiological procedures, hemodilution and hypothermia. No conclusive reports are possible on the role of pulmonary reinfusion or plasmatic and cellular mechanism of depression.

Adolescent↗

PubMedDate not supplied

[Effects of age, body weight, and ventilatory pattern on the difference between arterial and end-tidal PCO2].

OBJECTIVE: To evaluate the effects of physiological ventilatory patterns on P(a-ET)CO2 gradient and on the alveolar dead space production during controlled mechanical ventilation. DESIGN: Prospective and experimental comparison among three different ventilatory settings in three different groups of subjects. SETTING: General surgery's operating-theatre in university hospital. PATIENTS: Twenty-eight patients subdivided randomly in 3 groups differing for ventilatory setting. I group: constant tidal volume (VC = 8 ml.kg-1) and 3 different respiratory frequencies (f = 10, 12 and 14 breaths.min-1); II group: constant ventilation (112 ml.kg-1) but VC and f modified in three different ways; III group: inspiratory volume was set to give an end-tidal PCO2 (PETCO2) of about 35 mmHg. The cases were subdivided, on the basis of P(a-ET)CO2 distribution, in three groups: group with values larger than mean plus 1 standard deviation, group with values between +/- 1 standard deviation and group with values lower than mean minus 1 standard deviation. Moreover in two homogeneous groups for age. INTERVENTIONS: General surgery but not important because measures were performed before surgical manoeuvres. MEASUREMENTS AND MAIN RESULTS: Anthropometrical data (age and body weight), PaCO2, PETCO2, heart rate, invasive arterial pressure, ventilatory parameters and airway pressure were collected for every subject and ventilatory setting; arterial to end-tidal difference P(a-ET)CO2 and P(a-ET)CO2.PaCO2(-1) were calculated during data analysis. The P(a-ETFCO2 and P(a-ET)CO2.PaCO2(-1) values were not significantly different among the three different ventilatory patterns both in the first and in the second group. P(a-ET)CO2 values were significantly correlated with age, body weight and airway pressure. These parameters were correlated significantly also with P(a-ET)CO2.PaCO2(-1) values. CONCLUSIONS: Ventilatory setting, used in a normal physiological range, don't affect P(a-ET)CO2 difference during mechanical ventilation. Age, body weight and airway pressure of the patient must be considered to obtain a correct value of PaCO2 by the measure of PETCO2.

Adult↗