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C Pissaia

Publications and source records attributed to C Pissaia.

6 recordsLinked to original sources
PubMed1999

Prognostic meaning of temporary clipping in patients with intracranial aneurysm.

The prognostic meaning of the routine use of the methods of temporary clipping of the afferent vessel in patients with intracranial aneurysm (Grading 0-III) was the aim of the analysis in this study. In the period 1 January, 1991-31 December 1997, 304 patients underwent surgery for non-giant intracranial aneurysm and a follow-up angiography. 157 patients were operated by routinely using the temporary clipping of the afferent vessel, whereas in 147 patients the surgical procedure was performed by traditional methods. The statistical analysis showed a significant reduction (p < 0.001) in terms of risk of surgical complications in the patients who underwent surgery with the temporary clip method compared to those operated with the traditional method, with a relative risk of such complications about three times greater in the latter. The routine use of temporary clipping offers, therefore, the possibility of a significant improvement of the surgical results, not influenced by a further involvement for the structure, due to the short application time.

Aneurysm, Ruptured↗
PubMed1999

Total intravenous anesthesia with propofol and remifentanil for elective non-cardiac surgery.

BACKGROUND: Remifentanil is a highly effective mu opioid agonist with predictable pharmacokinetics and a close concentration-effect relationship. Moreover, studies on anesthetic drugs interactions show that optimal propofol concentrations decrease more significantly with remifentanil as compared with other opioids and recovery appears to be much faster than when propofol is combined with other opioids combinations. This intervention study was designed to evaluate the efficacy of propofol combined with remifentanil in elective non cardiac inpatient surgery. METHODS: N. 405 patients undergoing intraperitoneal, head-neck, intrathoracic, major orthopaedics, breast and major vascular surgery received: remifentanil (1 microgram.kg-1 at induction; 0.50 microgram.kg-1.min-1 at laryngoscopy; 0.25 microgram.kg-1.min-1 at skin incision; 0.25-0.30 microgram.kg-1.min1 from skin incision to end of skin suture) and propofol (0.5-1 mg.kg-1 at induction; 5 mg.kg-1.h-1 at laryngoscopy; 5 mg.kg-1.h-1 at skin incision and 5 mg.kg1.h1 thereafter). Intraoperative end-points included somatic responses, tachycardia and hypertension to laryngoscopy and surgery. Incidence of intraoperative bradycardia, hypotension and muscle rigidity were also recorded. Postoperative end-points included Aldrete score > or = 9, pain immediately following emergence and PONV. RESULTS: Propofol-remifentanil combination effectively controlled responses to laryngoscopy and surgical stress. Drug related adverse events were transient bradycardia (< 50 bpm) and hypotension (SBP < or = 80 mmHg) respectively: at prelaryngoscopy 11.60-1.48% and at pre-skin incision 10.61-0.98%. N. 365 patients were discharged from PACU and the median time to first Aldrete score > or = 9 was 22.3 min. The most frequent postoperative event was shivering recorded in n. 46 patients (12%). Postoperative analgesic medication was requested by n. 16 patients (4.4%) and PONV was noted in n. 6 patients (1.6%). CONCLUSIONS: When combined with propofol, remifentanil effectively provided for profound analgesia during surgery, stable anesthetic conditions, simplicity of use and predictable recovery.

Anesthesia, Intravenous↗
PubMed1992

[Neuroanesthesia during carotid thromboendarterectomy interventions].

The paper describes two techniques of anesthesia used during carotid thromboendarteriectomy surgery. The first technique utilises a mixture of O2-N2O, isofluorane and fentanyl as analgesic; the halogenate compound is not administered during carotis clamping and fentanyl is used for maintenance. The second technique is predominantly intravenous and utilises differing doses of propofol during the entire operation with fentanyl as an analgesic. The two techniques are comparable in terms of management and efficacy; the use of ECG monitoring is vital to identify possible intraoperative cerebral ischemic phenomena.

Aged↗
PubMed1991

[Ventricular pre-excitation syndrome: anesthesiologic aspects].

Two cases of pre-excitation syndrome are reported and the anaesthesiological management adopted is discussed. After a brief overview of the pathophysiology of the syndrome relative indications and contraindications of the main anaesthetic drugs and volatile agents are analyzed. The high incidence of perioperative atrial fibrillation, atrial flutter or supraventricular tachycardia and the importance of maintaining sinus rhythm is recalled. The task confronting the anaesthetist is to ensure an adequate level of anaesthesia during induction and maintenance while carefully selecting specific drugs associated with minor cardiovascular side effects. In the Authors' experience benzodiazepines, fentanyl, vecuronium and isoflurane have proved to be the most adequate choice for this type of patient.

Adult↗