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Biomedical subjects

D Beltrutti

Publications and source records attributed to D Beltrutti.

At least 19 recordsLinked to original sources
PubMed2001

[The benefit of combining spinal morphine and intravenous buprenorphine for perioperative pain].

Concurrent administration of opioids with different affinity produces synergistic antinociceptive effect in rats. We tested the perioperative antinociceptive effects of the simultaneous double blind administration of morphine, a pure agonist and buprenorphine, a partial agonist, in 30 patients undergoing hysterectomy under general anesthesia. Pre- and post-operatively regimens consisted of random patient assignment to intrathecal 0.3 mg morphine plus intravenous saline (group 1), intravenous 0.09 mg buprenorphine plus intrathecal saline (group 2) or intrathecal morphine 0.3 mg plus intravenous buprenorphine 0.09 mg (group 3). Postoperative pain relief for group 3 consisted of supplementation of intravenous buprenorphine plus intrathecal saline. The immediate postoperative pain, sedation and anxiety levels (by numerical or categorical scores) were similar among all groups. The 12-hour pain and sedation scores were significantly (P < 0.05) lower in group 3 than in the other two groups. Buprenorphine-induced analgesia in group 3 lasted significantly (P < 0.05) longer than in group 2. Side effects in groups 2 and 3 were by 44% and 42% fewer than in group 1, respectively, with no withdrawal symptoms. Thus, concomitant administration of intrathecal morphine and low dose intravenous buprenorphine produces better and longer pain relief than intravenous buprenorphine alone in women after hysterectomy.

Adult↗
PubMed1997

Complications of super-selective subarachnoid anesthesia (SSA) with hyperbaric bupivacaine: experiences with 355 patients in general and orthopaedic surgery.

The results obtained from 355 patients of both sexes subjected to general and orthopaedic surgery with super-selective subarachnoid anesthesia (SSA) by means of small (26-27 gauge) needles with a modified Whitacre needle with ogival point are described. The use of thin spinal needles with "pencil-point" type ends together with microdoses of local anesthetics has meant a reduction in the complications typical of this technique such as hypotension, post-dural puncture, headache (PDPH) and urinary retention. Super-selective subarachnoid anesthesia realised through an infusion of 0.8-1 ml of hyperbaric bupivacaine is a safe effective technique with a low percentage of side-effects.

Adolescent↗
PubMed1995

Some remarks on the current morphine consumption in Italy.

AIM: To analyse therapeutic morphine consumption in Italy and explain the current trend. ENVIRONMENT: Morphine consumption was examined at Santa Croce Hospital, Cuneo, a general provincial hospital. METHOD: The overall annual consumption of morphine was used as a starting point from which to evaluate the "average daily consumption of set doses", both in general and using a number of methods of administration. From these figures it was possible to calculate the average number of patients receiving full doses of the drug daily; this finding was compared every 10,000 days of hospitalisation. RESULTS: The analysis of consumption over the two-year period 1991-92 shows a 98.41% increase in mean morphine consumption compared to the period 1988-89. Over the five-year period the average number of patients receiving full doses of morphine daily through a variety of methods of administration was 9.89, equivalent to 3.79 patients every 10,000 days of hospitalisation. CONCLUSIONS: Useful information can be derived regarding the trend of morphine consumption from the "mean daily consumption of set doses" of morphine and, above all, from monitoring consumption per 10,000 days of hospitalisation. At present we are not aware of similar data relating to other hospitals. We hope that this lacuna will soon be filled so as to evaluate and monitor morphine consumption trends in Italy.

Drug Utilization↗
PubMed1992

Chronic low back pain patients around the world: cross-cultural similarities and differences.

OBJECTIVE: The current study sought to determine whether there were any significant cross-cultural differences in medical-physical findings, or in psychosocial, behavioral, vocational, and avocational functioning, for chronic low back pain patients. DESIGN: Partially double-blind controlled comparison of six different culture groups. SETTING: Subjects were selected from primarily ambulatory care facilities specializing in treating chronic pain patients. PATIENTS-SUBJECTS: Subjects consisted of 63 chronic low back pain patients and 63 healthy controls. Low back pain patients were randomly selected from six different culture groups (American, Japanese, Mexican, Colombian, Italian, and New Zealander). Ten to 11 were gathered per culture from a pool of patients treated at various pain treatment programs. Likewise, 10 or 11 control group subjects were obtained from each culture from a pool of healthy support staff. MAIN OUTCOME MEASURES: The Sickness Impact Profile and the Medical Examination and Diagnostic Information Coding System were used as primary outcome measures. RESULTS: Findings showed that (a) low back pain subjects across all cultures had significantly more medical-physical findings and more impairment on psychosocial, behavioral, vocational, and avocational measures than controls did; (b) Mexican and New Zealander low back pain subjects had significantly fewer physical findings than other low back pain groups did; (c) the American, New Zealander, and Italian low back pain patients reported significantly more impairment in psychosocial, recreational, and/or work areas, with the Americans the most dysfunctional; and (d) findings were not a function of working class, age, sex, pain intensity, pain duration, previous surgeries, or differences in medical-physical findings. CONCLUSIONS: It was concluded that there were important cross-cultural differences in chronic low back pain patients' self-perceived level of dysfunction, with the American patients clearly the most dysfunctional. Possible explanations included cross-cultural differences in social expectation; attention; legal-administrative requirements; financial gains; attitudes-expectations about usage, type, and availability of health care; and self-perceived ability and willingness to cope.

Adult↗
PubMed1992

[Compliance problems in chronic pain].

The aim of this paper is to focus on a medical issue which is not held in due consideration in Italy. In chronic pain control and management, specialists may advise at various times drugs, physical therapies, behavioral modification techniques, and not demolitive antinociceptive procedures. Quite often patients do not follow medical prescriptions as one should expect, especially if they are not inpatients. The Authors examine this clinical problem known as compliance and try to explain the reasons for this behaviour from different points of view.

Chronic Disease↗
PubMed1981

[The use of althesin in endoscopy].

Althesin was used on account of its pharmacokinetic and pharmacodynamic properties and its high therapeutic index in a search for a narcotic drug displaying minimal interference with metabolic and functional parameters in the aged. Continuous perfusion of the anaesthetic proved an extremely flexible method bearing in mind the varying length of the operations concerned. Stress is laid on the need for clinical control, especially at the moment of induction to ensure that timely action can be taken in the event of complications.

Aged↗
PubMed1980

[The terminal cancer patient. Problems of medical care and need for improvement].

On the basis of personal experience of many patients affected by neoplastic lesions, the conviction that the assistance provided to a terminal cancer patient in the hospital ward is deficient and takes no account of the medical, emotional, social and spiritual needs of the patient and his family, is expressed. It would be advisable for assistance to terminale patients to be supplied in adequate centres operating on multidepartmental bases, with the participation of experts in antalgic treatment and psychological problems.

Anxiety↗
PubMed1980

[Hypokalemic states in clinical practice. A case of severe hypokalemia combined with flaccid quadriplegia].

The biochemical data relating to the physiological distribution of potassium and its regulating factors in the normal human body are explained. Reference is then made to the clinical symptoms and aetiopathogenesis of hypokalaemia. A serious case coupled with flaccid quadriplegia in a 34-yr-old male is presented. Stress is laid on the usefulness of correct investigation of the history, and the fundamental resort to complete electrolytic screening in patients presenting with polyuria, polydipsia, arrhythmia and flaccid quadriplegia.

Adult↗
PubMed1980

[Althesin in "continuous perfusion" in urologic surgery; a preliminary note].

Althesin was used as the main anaesthetic in 44 urological operations. The "continuous perfusion" technique is described and an account is given of the main biological parameters, the features of the return to consciousness, and the secondary effects that make althesin particularly useful in lengthy operations on high-risk aged subjects.

Adult↗
PubMedDate not supplied

Persistent pain and personality evaluation. A report of seven multi-operated patients for chronic pain complaints of non malignant origin.

The MMPI scores, the PPI and the MPQ of seven multi-operated patients for chronic pain complaints of non malignant origin were studied. The results of the analysis performed in this group of surgically treated patients point out that there is a strong evidence of relationship between personality traits and the persistence of pain.

Adult↗