Biomedical subjects

F Giunta

Publications and source records attributed to F Giunta.

75 records · Page 5Linked to original sources

PubMedDate not supplied

Critical evaluation of a new water soluble contrast medium (Iopamidolo) in cervical myelograms.

The Authors report the preliminary results in 96 cervical myelograms performed by percutaneous subarachnoid injection at the level C1-C2 of a new water soluble contrast medium (Iopamidolo*). Compared to other water soluble contrast media Iopamidolo offers some advantages: (1) it is a time stable solution ready for immediate use; (2) it gives an ideal density for the study of the cervical spinal canal; (3) it provides high quality radiograms suitable for magnification of anatomical details which give a more accurate surgical diagnosis; (4) it is well tolerated without significant sequelae; no delayed complications were reported up to 15 months. This contrast medium gives valuable results also in myelograms performed by lumbar route.

Humans↗

PubMedDate not supplied

Alkalinization of local anesthetics. Which block, which local anesthetic?

BACKGROUND AND OBJECTIVES: A number of clinical studies have been performed in an attempt to establish the effects of alkalinization on potency of local anesthetics. Conflicting results were obtained probably because different studies used different methods as well as different definitions of the effects. To determine the efficacy of alkalinization using different local anesthetic solutions and different regional blocks, 180 patients were studied in a randomized, double-blind fashion. The local anesthetic solutions studied were bupivacaine, mepivacaine, and lidocaine; the regional blocks studied were epidural block, axillary brachial plexus block, and femoral and sciatic nerve block. MATERIALS AND METHODS: In this study, 180 patients receiving epidural block (n = 60), sciatic and femoral nerve block (n = 60), and brachial plexus block (n = 60) were randomized to receive, in a double-blind fashion, a plain or a pH-adjusted solution of 2% mepivacaine, 2% lidocaine, or 0.5% bupivacaine. Onset of sensory analgesia, onset of maximum effect (peak effect or complete analgesia), duration of the block, onset, duration and density of motor block were evaluated using pinprick (Hollmen scale) and a 10-point decimal scale (Seow scale). RESULTS: concerning epidural block, the alkalinization of the local anesthetic shortened significantly the onset of sensory analgesia in the dermatome corresponding to the lumbar interspace used for epidural puncture (L3-L4) and increased the spread of the epidural block in all the groups. The onset of sensory analgesia at L4 level ranged from 10 minutes for plain bupivacaine to 3 minutes for alkalinized lidocaine, whereas the onset at T10 level ranged from 16 minutes for plain bupivacaine and mepivacaine to 12.3 minutes for alkalinized lidocaine. The effects of alkalinization were more evident with lidocaine and bupivacaine. Concerning femoral and sciatic nerve blocks, a statistically significant shorter onset of sensory analgesia and motor block were observed with mepivacaine. Concerning brachial plexus axillary block, the effects of alkalinization were more evident with lidocaine. CONCLUSIONS: Alkalinization produced the best results with lidocaine and bupivacaine for epidural block, with lidocaine for brachial plexus block, and with mepivacaine for sciatic and femoral nerve blocks.

Adult↗

PubMedDate not supplied

[Comparison of bench central and mixed pulmonary venous oxygen saturation in critically ill postsurgical patients].

OBJECTIVE: To investigate if there were differences between bench central oxygen saturation (ScvO2) and mixed venous oxygen saturation (SvO2) in a group of acutely ill postsurgical patients. DESIGN: A prospective comparative study of two sampling sites. SETTING: Postsurgical ICU at a University Hospital. PATIENTS: 39 acutely ill postsurgical patients, requiring perioperative invasive hemodynamic monitoring, studied during their stay in a postsurgical ICU. INTERVENTIONS: Routine care for acutely ill postsurgical patients. MEASUREMENTS AND MAIN RESULTS: Blood was simultaneously sampled, according to the clinical course, both from the distal and central port of a pulmonary artery catheter (n = 296 each). Oxygen saturation and blood gas analysis were immediately measured with a CO-oxymeter and a blood gas analyzer. We investigated the relationship and the agreement between the two measures. To assess if bench ScVO2 could give information on time related variations of bench SvO2 we evaluated the absolute sequential changes of the two measures during the period of observation, by analyzing the relationship and the agreement of their absolute changes (n = 1817). There was a significant difference between bench SvO2 and bench ScvO2 (71.8 +/- 8.2 vs 72.7 +/- 8.6% mean +/- SD, p < 0.001). The relationship between the two measures showed a significant correlation (r = 0.90, p < 0.001, and SEE 3.8%). The bias was -0.93 +/- 3.8%, and the limits of agreement were +6.6 and -8.5%. The changes in bench ScvO2 correlated with the respective changes in bench SvO2 (r = 0.86, p < 0.001, and SEE 4.4%). The bias was 0.79 +/- 4.7% and the limits of agreement were +9.4 and -7.8%. CONCLUSIONS: SvO2 cannot be predicted well from bench ScvO2, nor changes in ScO2 can be predicted wel from changes in bench ScvO2. Therefore, in this category of patients, the clinical usefulness of monitoring bench ScvO2 is strongly limited and we must still rely on the SvO2.

Adolescent↗