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Biomedical subjects

M Della Rocca

Publications and source records attributed to M Della Rocca.

10 recordsLinked to original sources
PubMed2006

Lateral popliteal sciatic nerve block: a single injection targeting the tibial branch of the sciatic nerve is as effective as a double-injection technique.

BACKGROUND: Evidence indicating that single- and double-injection techniques for inducing a sciatic nerve block via a posterior subgluteal approach yield a similar success rate prompted us to investigate whether the two anesthetic techniques yield a similar success rate via a lateral approach. We also hypothesized that, owing to the peculiar anatomic features of the sciatic nerve at the popliteal level, a single injection via the lateral approach might induce effective anesthesia by targeting the tibial nerve only. METHODS: Ninety-six patients undergoing popliteal sciatic nerve block via a lateral popliteal approach for foot surgery were randomized to receive a single 30-ml injection of ropivacaine 7.5 mg/ml to block the tibial nerve (TN group, n= 32) or the common peroneal nerve (CPN group, n= 32), or two separate 15-ml injections (TN + CPN group, n= 32), after stimulation to evoke motor responses from the target nerves. RESULTS: The mean time to obtain a complete sensory blockade (surgical anesthesia) was shorter in the TN group than in the CPN and TN + CPN groups (14 +/- 7 min vs. 23 +/- 17 and 21 +/- 14 min, respectively; P < 0.05). The success rate was similar in the TN and TN + CPN groups (94%) and, 25 min after the initial injection, was already better in these groups than in the CPN group (94% vs. 75%; P < 0.05). CONCLUSIONS: A lateral popliteal sciatic nerve block obtained with a single 30-ml injection of ropivacaine 7.5 mg/ml after electrostimulation to locate the tibial nerve is as effective as multiple TN + CPN stimulation and injection, and local anesthesia has a significantly shorter onset time.

Amides↗
PubMed2003

Anesthesiologic aspects of laparoscopic fundoplication for gastroesophageal reflux in children with chronic respiratory and gastroenterological symptoms.

INTRODUCTION: During the past three decades laparoscopy has significantly improved. As fundoplication extensively benefits by the great advantages of the minimally invasive approach, many surgeons chose laparoscopic fundoplication for the treatment of gastroesophageal reflux in adults and children as well. Pneumothorax, cardiovascular collapse, hypoxia, and hypercarbia are some of the anesthesiologist's principal fears during carbon dioxide insufflation. Thus, monitoring cardiovascular and respiratory status is mandatory to early detect any complication and to maintain a proper balance during pneumoperitoneum. MATERIALS AND METHODS: At Gaslini Children's Hospital we performed a prospective nonrandomized study aimed at describing the main cardiorespiratory changes produced by pneumoperitoneum in 33 pediatric patients operated on by laparoscopic fundoplication between January 2000 and June 2001. Patients were divided into two groups; namely, group A and group B. Group A included 14 patients with chronic respiratory symptoms, and group B included 19 children who preoperatively mainly emphasized gastrointestinal symptoms. We monitored intraoperative cardiorespiratory status, timed length of surgery, and described intraoperative complications. RESULTS: No significant cardiovascular changes occurred during carbon dioxide insufflation. Partial oxygen saturation remained still in all the patients. End tidal CO2, meanly higher in group A children, increased in all the patients after pneumoperitoneum creation, but never exceeded 45 mmHg. Similarly, peak inspiratory pressure increased in all the patients, but was always maintained within acceptable values. Finally, group B patients required a harder and slower surgery, whose length seems to be negatively influenced by age. No intraoperative complication occurred. CONCLUSIONS: Carbon dioxide insufflation does not impair cardiovascular function, if intraabdominal pressure is maintained lower than 10 mmHg nor does it interfere with gas exchanges. Pneumoperitoneum slightly reduces ventilatory function, mainly in respiratory patients with various degrees of underlying bronchopulmonary impairments, but this effect is easily correctable. Thus, laparoscopic fundoplication is feasible and safe in both respiratory and gastroenterological patients, although surgery is easier and faster if periesophagitis is less evident.

Anesthesia↗
PubMed2001

Ambulatory anesthesia for foot surgery.

Ambulatory surgery has developed extensively over the past few years in most Western countries. The absence of specific legislation in Italy creates a lack of trust in patients and interferes with the development of this discipline. The authors describe their experience in the organisation of an outpatient foot surgery centre over the past thirteen years, which is in constant expansion and currently performs about 300 operations every year. They report the criteria used to select patients, the organisation of the operating theatre, pre- and postoperative treatment and the anesthetic techniques used. Among the latter, they describe a new approach used to block the popliteal sciatic nerve. The results obtained show a high approval rate from the majority of patients treated. The authors attribute this success to a series of factors, including patient selection and surgical procedures, the maintenance of constant standards of quality similar to those in hospitals and the experience of outpatient anesthesia.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Event-related potentials and autonomic functions.

The authors pointed out how some of the anatomic structures involved in the genesis of the event related potentials (ERPs) are also considered parts of the supranuclear regulation apparatus of the autonomic nervous system. Since there are evident functional similarities between some components of the ERPs and the orienting reflex--primitive form of attention--that is clearly associated with an autonomic activation, it could be interesting to evaluate the parameters of the ERPs in those experimental and clinical situations in which there is a functional involvement of the vegetative nervous system.

Autonomic Nervous System↗