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F S Venuti

Publications and source records attributed to F S Venuti.

At least 19 recordsLinked to original sources
PubMed1995

A multifactorial analysis to explain inadequate surgical analgesia after extradural block.

A multivariate analysis of inadequate extradural analgesia was carried out prospectively on 1051 patients undergoing lumbar extradural anaesthesia for surgery performed on structures innervated by T10-S5. Ninety-six patients (9%) experienced pain during surgery. Age, extradural fentanyl, diazepam sedation and duration of surgery had no significant influence. We found some weak evidence that the type of surgery affects the risk of feeling pain. The probability of pain increased with increasing weight, except in overweight women, and was significantly greater for both shorter and taller patients, relative to patients of average height. The probability of pain decreased with increasing dose of local anaesthetic, increasing spread of extradural analgesia, addition of adrenaline, and fentanyl or thiopentone sedation. In conclusion, patient-, surgery- and anaesthesia-related factors influence the risk of inadequate extradural analgesia. If such factors are taken into account, an increase in the success rate may be anticipated.

Adolescent↗
PubMed1995

Failure rate of epidural anaesthesia for foot and ankle surgery. A comparison with other surgical procedures.

To test whether epidural anaesthesia for foot and ankle surgery is associated with an unacceptably high incidence of inadequate surgical analgesia, we prospectively compared two groups of patients, one undergoing foot or ankle surgery (160 patients) and the other surgical procedures not performed in areas innervated by L5-S1 ( (168 patients). Lumbar epidural anaesthesia was performed in both groups by administering carbonated lignocaine 2% with adrenaline 1:200000. Seven patients in the foot-ankle group (4.4%) and 10 in the group for comparison (5.9%) exhibited inadequate surgical analgesia. This difference is not statistically significant. Within the foot-ankle group, a significantly lower dose of local anaesthetic per spinal segment had been given to patients who displayed inadequate analgesia, compared with those who exhibited satisfactory analgesia (P < 0.05).

Adjuvants, Anesthesia↗
PubMed1994

A multifactorial analysis of the spread of epidural analgesia.

The controversies about the factors determining the spread of epidural analgesia are partly due to inappropriate methodology or sample size of previous studies. We performed a multivariate regression analysis on 803 ASA class 1-2 non-atherosclerotic adults, undergoing lumbar epidural anaesthesia according to a predefined standardised procedure. The spread of epidural analgesia is more accurately studied by analysing dose/segment (R2 = 0.671) instead of spread (R2 = 0.271) as dependent variable. The impact of local anaesthetic (2% lidocaine CO2 or 0.5% bupivacaine) and addition of adrenaline is not significant. Spread significantly increases with increasing age, weight, body-mass index, dose of local anaesthetic, addition of fentanyl, higher site of injection, and decreasing body height. The impact of age and dose is higher under the age of 40 and at doses lower than 20 ml. Increasing the total dose increases the dose needed to block one spinal segment. Unknown idiosyncratic factors still determine a certain proportion of the sample variance. The addition of adrenaline to lidocaine and the use of bupivacaine improve the predictability of spread. In conclusion, we found clinically significant correlations between a group of factors and epidural spread. Alternative anaesthetic solutions lead to different degrees of predictability.

Adolescent↗
PubMed1994

[Comparison of carbonated lidocaine and mepivacaine in epidural anesthesia].

OBJECTIVE: To compare carbonated mepivacaine to carbonated lidocaine in epidural anaesthesia. DESIGN: Nonrandomised control trial. SETTING: University Hospital. PATIENTS: Forty patients undergoing epidural anaesthesia for orthopaedic surgery. METHODS: Epidural anaesthesia at the fourth lumbar interspace, administering either carbonated mepivacaine 20 ml (group M, 20 patients) or carbonated lidocaine 20 ml (group L, 20 patients). Parameters recorded: onset of sensory block (time required to reach L1 and time required to reach the upper level), cranial spread of analgesia (number of dermatomes), duration of block (time between achievement of maximum spread of analgesia and regression of sensory block by two dermatomes) and motor block (Bromage score). RESULTS: No statistically significant differences have been found between group M and group L in the time required to reach L1 (means and standard deviations 6.3 +/- 3.8 and 6.5 +/- 2.1 minutes, respectively), in the time required to reach the upper level of analgesia (means and standard deviations 14.3 +/- 4.2 and 16.5 +/- 3.5 minutes, respectively), in the cranial spread of analgesia (means and standard deviations 7.1 +/- 3.4 and 7.6 +/- 2.7 dermatomes, respectively) and in the degree of motor block (means and standard deviations 1.5 +/- 0.8 and 1.1 +/- 0.8, respectively). Group M exhibited a much higher duration of sensory block, compared to group L (means and standard deviations 91.6 +/- 20.2 and 58.8 +/- 23.4 minutes, respectively, p < 0.001). CONCLUSIONS: Carbonated mepivacaine is more indicated than carbonated lidocaine in epidural anaesthesia when a high duration of sensory block is desired.

Adult↗
PubMed1992

[Postoperative pain in shoulder surgery].

Postoperative shoulder pain should be adequately treated not only because of the high severity of the symptomatology often observed, but also because pain and muscle contraction render impossible an early rehabilitation programme. Regional anaesthesia, by virtue of its beneficial effects on the pathophysiology of pain and its influence on the rehabilitative problems of shoulder surgery, is the most adequate technique for the control of postoperative pain.

Analgesia↗
PubMed1991

[Pressure changes in the middle ear during nitrous oxide anesthesia].

We studied middle ear pressure variations in 17 patients with mild upper airways or middle ear diseases, during nitrous oxide anaesthesia. We observed a significant increase in middle ear pressure during the administration of nitrous oxide, and a significant decrease after nitrous oxide was discontinued. Nine patients showed periodical reductions of the middle ear pressure during the inhalation of nitrous oxide, due to passive openings of the eustachian tube. In the remaining 8 patients (47%) this mechanism has not been effective. A comparison between these two groups shows significantly higher levels of middle ear pressure in the group of patients with abnormal function of the eustachian tube, both during and after the administration of nitrous oxide. Our results demonstrate that patients with mild upper airways or middle ear diseases are likely to show an impaired tubal function. Therefore, nitrous oxide should be used with caution in the presence of such diseases. Moreover, nitrous oxide is generally controindicated in middle ear surgery, as the pressure gradients between middle and external ear can jeopardize the success of the operation.

Adult↗
PubMed1990

[Comparison of a combination of fentanyl and alfentanil with propofol in brief surgery].

We studied 96 patients undergoing short gynecological procedures. Anaesthesia has been induced with fentanyl 1.5 micrograms/kg (45 patients) or alfentanil micrograms /kg (51 patients) and a hypnotic dose of propofol, and maintained with 70% N2O via facial mask. We observed a better and more rapid control of surgical analgesia with alfentanil, and an earlier recovery of postoperative psychophysical functions. Post-induction apnea has been more frequent and prolonged in the alfentanil group, but no difference in the time necessary to recover an adequate ventilation has been observed between the two groups. Alfentanil anaesthesia determined a more marked intraoperative bradycardia. By virtue of the speed of onset and the short duration of action, alfentanil is a suitable anaesthetic agent for short surgical procedures, particularly in day-stay patients.

Adult↗
PubMed1990

[New methods of electrophysiologic investigation in the diagnosis of brain death].

In the event of suspected brain death it is vital to arrive at a diagnosis as rapidly as possible and with the least chances of error. The paper examines the potentially and possible value of BAER recordings. Results are in line with those of other published studies which underline the value of this method, in spite of the fact it is limited by the possible presence of numerous factors which might invalidate recordings.

Brain Death↗
PubMed1989

[Muscular rigidity caused by alfentanil: prevention].

We studied three groups of 30 patients each, undergoing minor orthopaedic surgery, anaesthetized with alfentanil (30 micrograms/kg bolus followed by an infusion of 0.3 micrograms/kg/min), thiopental 3 mg/kg and 70% N2O via facial mask. Patients in group I were treated, three minutes before induction, with vecuronium 0.02 mg/kg i.v., while those in group II were premedicated with diazepam 0.15 mg/kg i.m. 30-45 minutes before induction. Group III served as control. Muscular rigidity was evaluated clinically with a subjective score based on a scale of 0 (no rigidity) to 3 (severe rigidity). Diazepam did not give significant protection from muscular rigidity. Vecuronium administration did not significantly reduced the number of patients who became rigid, but significantly decreased the incidence of severe rigidity (p less than 0.005), the mean rigidity score (p less than 0.05) and the incidence of rigidity at the induction of anaesthesia (p less than 0.0005). We also observed a progressively increasing incidence of rigidity with increasing age (not significantly) and body weight (p less than 0.05 total rigidity, p less than 0.01 severe rigidity).

Adolescent↗
PubMed1989

[Anesthesia for shoulder surgery. Comparison of anesthesiologic problems and technics].

We evaluated the ability of general, regional (interscalene block) and balanced anaesthesia (interscalene block supplemented by general anaesthesia) to manage the problems of shoulder surgery. Our results show that general anaesthesia is not adequate. Interscalene block provides intra and postoperative analgesia, allows an early realization of the postoperative rehabilitation programme and quickens the recovery of shoulder function. Therefore, interscalene block should routinely be performed. The positions of patient and surgeons cause the main disadvantages of anaesthesia with interscalene block alone, ad the control of airway of sedated patients is difficult and performing general anaesthesia in case of insufficient analgesia may be troublesome. Balanced anaesthesia, as compared to regional block alone, allows a safer control of respiration and an easier control of surgical analgesia.

Adult↗