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Biomedical subjects

G Cipriani

Publications and source records attributed to G Cipriani.

36 records · Page 2Linked to original sources
PubMed1991

[Post-operative analgesia with sub-arachnoid fentanyl: ventilatory effects in elderly patients].

Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group D, n = 7) for a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before 90, 150, 480 minutes after the subarachnoid injection. In group A mild pruritus and sedation occurred in 5 patients, nausea, vomiting and periodic breathing occurred in 2 patients. In group B mild pruritus and sedation were observed in 4 patients, nausea, vomiting in 2 patients. No significant changes in VE, Vt/Ti and Ti/Ttot were observed between the groups. Patients receiving 50 micrograms of fentanyl showed a slope VE/PET CO2 significantly below baseline values at 90 and 150 minutes (p less than 0.05). In this group the baseline values were restored after 480 minutes. No side effects were observed in group C and D. 25 micrograms fo fentanyl is the only dose with a significant analgesic effect without any respiratory depression.

Aged↗
PubMed1987

[Neurotraumatology and post-traumatic epilepsy. Prevention, treatment and long-term follow-up. Barbexaclone + phenobarbital (maliasin) versus diphenylhydantoin, phenobarbital, primidone, carbamazepine].

A report is presented on 58 patients (46 males, 12 females) all suffering from post-traumatic epilepsy (PTE) and followed up for a minimum of 1 year to maximum of 23 years after the injury (mean 6.3 years). The type and site of the head injury, the nature of the brain lesions, the time elapsing before the first critical manifestation, the clinical character of the epileptic attacks, EEG, cerebral CAT and RMN data were performed are given for all patients. The therapeutic and prophylactic strategies adopted are then described in detail with particular emphasis on the use of diphenylhydantoin (DPH) and barbexaclone. The latter drug, used for the last 3 years was found to be particularly useful in the treatment of patients suffering from a post-traumatic psycho-organic syndrome in addition to the PTE.

Adolescent↗
PubMedDate not supplied

Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution.

STUDY OBJECTIVE: To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. DESIGN: Randomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study. SETTING: Inpatient obstetric department at a general hospital. PATIENTS: Seventy patients scheduled for elective cesarean section under epidural anesthesia. INTERVENTIONS: Two groups of 35 patients each receiving either the standard commercial preparation of mepivacaine or the pH-adjusted solution (prepared with the addition of 0.1 meq/ml of sodium bicarbonate to the standard commercial solution). MEASUREMENTS AND MAIN RESULTS: Measurements of sensory (pinprick) and motor (Bromage's criteria) block were taken at 1- to 2-minute intervals beginning after the completion of the epidural injection. Increasing the pH of the mepivacaine resulted in a significant shortening of the time of analgesia onset (9.3 minutes compared with 16.01 minutes, p less than 0.01) and of peak effect (11.1 minutes compared with 21.2 minutes, p less than 0.01). The alkalinization did not affect duration of the block, intensity of motor block, or mean dose of local anesthetic used. CONCLUSION: The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.

Adult↗
PubMedDate not supplied

Epidural analgesia during and after cesarean delivery. Comparison of five opioids.

A randomized, double-blind study was designed to determine the effects on maternal intraoperative analgesia of adding one of the following opioids to the local anesthetic at the onset of epidural block, before surgery and neonatal delivery: morphine (3 mg), fentanyl (75 micrograms), sufentanil (50 micrograms), buprenorphine (0.3 mg) and oxymorphone (1 mg). The duration of postoperative analgesia, the presence of side effects and the neonatal outcome were also studied. Ninety healthy multiparas, at term, undergoing elective cesarean delivery using lumbar epidural anesthesia with 2% lidocaine were randomized in six equal groups to receive one of the opioids or saline. The predelivery administration of morphine, fentanyl and sufentanil significantly improved the intraoperative analgesia. Patients who received fentanyl, sufentanil, buprenorphine or oxymorphone had more somnolence than the others (p less than 0.01), but this did not interfere with the first mother-infant relationship during surgery. Patients in the buprenorphine group had more vomiting during surgery when compared with the others (p less than 0.01). Morphine provided the longest pain-free interval, followed by oxymorphone, buprenorphine, sufentanil and fentanyl. Postoperatively, the number of patients having pruritus and vomiting was significantly higher in the morphine and buprenorphine groups, respectively (p less than 0.01 versus others). No adverse neonatal effects were noted in any group.

Adult↗
PubMedDate not supplied

Extracorporeal blood recirculation and beta-2-microglobulin plasma levels during hemodialysis.

Beta-2-microglobulin (beta 2m) plasma levels during hemodialysis have recently been considered markers of membrane biocompatibility. The aim of this study was to assess if generation of beta 2m from blood cells in contact with the membrane could account for changes in beta 2m plasma concentration during hemodialysis. The role of heparin was studied as well by comparing conventional with heparin-free dialysis. beta 2m plasma levels were measured in six patients during 12 Cuprophan (Cu) and 12 Eval (E) non-consecutive hemodialysis sessions without ultrafiltration. E membranes were compared with and without heparin. beta 2m plasma levels significantly increased with Cu but not with E. A total of 200 ml of blood from four other patients was recirculated ex vivo before Cu hemodialysis in Cu or E and then reinfused into the patient. A drop in beta 2m concentration was observed in the recirculating blood, recovery of beta 2m from the washed filter was higher with E, and reinfusion of recirculated blood to the patient was not associated with significant increases in beta 2m plasma levels. Hemodialysis with a new Cu filter, following reinfusion, did not produce significant increase in plasma beta 2m concentration. In conclusion, 1) beta 2m plasma levels change during Cu, but are not associated with hemoconcentration from ultrafiltration nor with local release from the blood leaving the filter, 2) beta 2m binding to the membrane may account for decreased levels in recirculated blood, 3) E membranes both with and without heparin do not increase beta 2m plasma levels and reinfusion of recirculated blood blunts the beta 2m changes observed with Cu.

Aged↗