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G Della Rocca

Publications and source records attributed to G Della Rocca.

59 records · Page 4Linked to original sources

[Single lung transplantation: experimental technique and functional results].

Single lung transplantation was performed in 22 pigs. The first 10 experiments were devoted to settle the surgical technique: in these cases we employed small animals (8-12 kg); technical difficulties and the high incidence of perioperative complications induced us to utilize bigger animals (greater than 20 kg) in the subsequent experiments. In the recipient, after left pneumonectomy we prepared the right pulmonary artery and encircled it with an inflatable silicon cuff connected to a reservoir positioned outside the chest cavity of the animal. The inflation of the cuff allows the complete occlusion of the right pulmonary artery and thus the functional evaluation of the isolated transplanted lung. Perioperative functional evaluation has been performed at different times till the third postoperative day, documenting the good status of the transplanted lung. This study confirms the possibility to employ pigs for experimental single lung transplantation to settle the surgical technique with economic and organizing advantages. Furthermore, it confirms the good results achieved in the dog, in which the occlusion of the contralateral pulmonary artery by means of an inflatable silicon cuff allows to evaluate the isolated transplanted lung function.

Anesthesia↗

Atracurium, cisatracurium, vecuronium and rocuronium in patients with renal failure.

AIM: The cumulative index, the recovery, the onset and the duration of action, of atracurium, cisatracurium, vecuronium and rocuronium in uremic patients undergoing kidney transplantation compared to healthy patients undergoing general surgery were studied. METHODS: In all patients (64 uremic vs 62 "healthy" patients) after anesthesia induction, atracurium 0.5 mgxkg(-1) or cisatracurium 0.15 mgxkg(-1) or vecuronium 0.1 mgxkg(-1) or rocuronium 0.6 mgxkg(-1) were administered, and at the end of surgery when T1 reached 25% neostigmine 0.05 mgxkg(-1) was given. Neuro-muscu-lar transmission was monitored by accelerometry (TOF-GUARD, Organon). RESULTS: Cumulative index of vecuronium (1.3+/-0.1 vs 1.06+/-0.11, p<0.001) and rocuronium (1.45+/-0.18 vs 1.04+/-0.16, p<0.001), recovery index (time of T1 25-75) of atracurium (14.2+/-5 vs 9+/-4, p<0.005), cisatracurium (18.7+/-3 vs 9.1, p<0.001), vecuronium (18.5+/-3 vs 12.5+/-3, p<0.001) and rocuronium (18+/-6 vs 11+/-4, p<0.001) and interval T1 25% to TOF 0.8 of cisatracurium (20.5+/-1.2 vs 16+/-2.1, p<0.001) and vecuronium (27+/-6.3 vs 20+/-3.3, p<0.001) were longer in uremic patients. The onset time and the duration of action of atracurium, cisatracurium, vecuronium and rocuronium were similar in all groups compared to controls one. CONCLUSION: In patients with renal failure the use of atracurium, cisatracurium, vecuronium and rocuronium is suitable and predictable in terms of onset, and duration of action. Care has to be taken to vecuronium and rocuronium cumulative index. Neuromuscular trasmission has to be always monitored.

Adult↗

Comparison between spinal anaesthesia and sciatic-femoral block for arthroscopic knee surgery.

AIM: We compared spinal anesthesia and sciatic-femoral block for arthroscopic knee surgery in terms of hemodynamic changes, intraoperative anesthesia, postoperative analgesia, postoperative motor block and bladder function, side effects, and patient satisfaction. METHODS: Thirty-two patients were randomised into 2 groups: Group B (sciatic-femoral block with mepivacaine 1% 15 + 25 mL, 120 mm/35 mm 22-gauge needles and ElectroNerve Stimulator) and Group S (unilateral spinal anesthesia with 7 mg of hyperbaric bupivacaine 0.5% and 25-gauge Sprotte needle in L2-L3 space). We recorded pain, together with hemodynamic parameters (baseline, 5, 10, 15, 30 min), utilising Numerical Rating Scale (NRS) during the tourniquet application and during the surgical procedures, anesthesia quality, orthopedic evaluation for intraoperative liberty of knee movement. During the postoperative period we recorded at 2, 4 and 6 h: postoperative analgesia, motor block, first urine output, side effects, first requirement for analgesic drug, patient satisfaction and costs. RESULTS: The only significant differences between the 2 groups (P<0.05) were the heart rate changes at 10, 15, 30 min with an increase in Group B and a decrease in Group S, and the first urine output at 200+/-69 min in Group B versus 269+/-66 min in Group S. CONCLUSION: In conclusion the sciatic-femoral nerve block is a valid alternative to spinal anesthesia for arthroscopic knee surgery, leading to a faster discharging from the hospital.

Adult↗

[The selection of patients who are candidates for lung transplantation].

From January 1991 to September 1993 we evaluated 49 patients (27 males and 22 females--mean age 42 years) with chronic respiratory failure as possible candidates for lung transplantation. 27 patients had idiopathic pulmonary fibrosis, 9 emphysema, 4 bronchiectasis, 3 cystic fibrosis, 3 primary pulmonary hypertension and 1 respectively lymphangiomatosis, thromboembolism and vanishing lung. 16 patients were considered suitable for single or double lung transplantation. 4 patients died waiting, 4 underwent single lung transplantation and 8 are still on the waiting list. The mean survival of patients in the waiting list was 145 days (52 for patients with idiopathic pulmonary fibrosis), ranging between 35 and 398 days.

Adult↗