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M Sebastiani

Publications and source records attributed to M Sebastiani.

83 records · Page 5Linked to original sources
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

[Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].

A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h. The PCA system was set to deliver bolus of either morphine 1 mg or buprenorphine 0.03 mg, with a lockout interval of 10 and 15 min respectively. A loading dose of morphine 5 mg or buprenorphine 0.15 mg was given if necessary. The quality of analgesia, assessed by a visual analogue and a subjective scale was good with both drugs. No difference in side effects between the groups was observed. The mean potency ratio between buprenorphine and morphine was 32:1. Patients receiving buprenorphine showed a more prolonged analgesia and a significant improvement of sedation score.

Adult↗
PubMedDate not supplied

[Natural history of synchronous hepatic metastases from a non-treated colorectal cancer].

The authors present a retrospective study concerning 135 cases of untreated synchronous metastases from colorectal cancer. The median survival is 5.5 months and the natural history is depending on the percentage of liver replacement, on the "performance status" of each patient and on the stage of primary tumors classified according to Dukes. The seric levels of Alkaline Phosphatase and CEA are other useful prognostic factors. The age of patients and systemic chemotherapy (5-Fluorouracil) are not able to influence the evolution of the disease. At last different techniques, both curative and palliative, used in the current treatment of liver metastases from colorectal cancer are discussed and the reported survival improvements reaching with these forms of treatment are compared to the natural history of the disease.

Adult↗
PubMedDate not supplied

[Inguinal hernia in children].

The authors report 611 cases of inguinal hernias of childhood operated between 1967 and 1985, which represent 28% of operations performed in all children in the same period. The mean age of patients was 33 +/- 4.1 months and the ratio M:F = 5.43:1. The right side was the most frequently affected (64.64%) with a bilaterality of 14.89%. The incarceration, observed at the rate of 13.23%, needed the surgical treatment in urgency in the 35.63% of the cases. A relapsing hernia appeared only two times (0.45%) and the incidence of contralateral metacronous hernias was 7.99%. They perform herniorrhaphy in the only symptomatic side without preoperative herniorrhaphy and operate on the silent contralateral side only when there a hernia will became symptomatic, as they think that herniorrhaphy and bilateral inguinal exploration cause a high number of unnecessary, sometimes harmful operations.

Child↗
PubMedDate not supplied

[Immunology and tumors. Effector cells].

Since Burnet expounded the theory of immune surveillance, various cells have been indicated as the "effectors" of the body immunological defence against tumours. Until recently, the ability to lyse tumour target cells was assigned to macrophages and the so-called thymus-dependent lymphocytes, known as killer T cells. The discovery of natural killer cells in mice recently has widened the number of effectors and the field of research in this sector. An examination is made of the features and main properties of these cell groups, and some questions are posed concerning their ability to cooperate in anti-neoplastic immunological defence.

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