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Biomedical subjects

V Bachiocco

Publications and source records attributed to V Bachiocco.

18 recordsLinked to original sources
PubMed2004

Exposure of personnel to sevoflurane during paediatric anaesthesia: influence of professional role and anaesthetic procedure.

BACKGROUND AND OBJECTIVE: This study was performed to determine the individual exposure of paediatric operating theatre personnel to sevoflurane and to evaluate the impact of inhalation induction and various airway approaches on exposure to airborne sevoflurane. METHODS: Mean individual environmental (workplace air) exposure to sevoflurane and a biomarker of exposure (urinary sevoflurane) were monitored in 36 subjects (10 anaesthetists, 10 surgeons, 12 nurses and 4 auxiliary personnel) working in two paediatric operating rooms. RESULTS: Environmental and urinary values were significantly greater in anaesthetists compared with other groups, with median values of 0.65ppm (interquartile range 1.36; 95th percentile 4.36) for breathing zone sevoflurane and 2.1 microgL(-1) urine (interquartile range 2.6; 95th percentile 7.6) for urinary sevoflurane. Anaesthetists exceeded the 2ppm maximum allowed environmental concentration recommended by the National Institute for Occupational Safety and Health in 4 of 22 cases (18.1%). A positive correlation was found between the number of patients undergoing inhalational induction each day and mean values of breathing zone and urinary sevoflurane. An increase in the number of daily laryngeal mask insertions, or the use of rigid bronchoscopy, are statistically related to higher environmental and urinary values (P < 0.01 and <0.00001 for breathing zone sevoflurane, P < 0.05 and <0.01 for urinary sevoflurane, respectively). CONCLUSIONS: Anaesthesia with sevoflurane can pose a hazard of chronic exposure with anaesthetists having the highest risk. Endotracheal intubation offers considerable protection against exposure. Routine anaesthesia using a standard facemask, a laryngeal mask or rigid bronchoscopy are risk factors for increased anaesthetic exposure.

Adult↗
PubMed2004

Peripherally inserted central venous catheters in preterm newborns: two unusual complications.

This report describes the case of two newborns who suffered unusual complications after peripheral insertion of a central venous catheter. In one baby a fragment of the catheter tip became embolized in a peripheral branch of the left pulmonary artery. In the other baby, the catheter perforated a peripheral branch of the pulmonary artery, giving rise to chemical pneumonitis with extensive pleural effusion. The outcome was positive for both babies. A large clinical series is necessary to establish the complications of this procedure, their prevention and management.

Catheterization, Central Venous↗
PubMed1999

[Inhalation of foreign bodies].

Accidental aspiration of a foreign body (FB) is an event which is reasonably frequent and dramatic in children and is still today one of the main causes of death due to accidents at home in children up to three-four years of age. The severity of the clinical picture varies according to the size, shape, type and site of arrest of the material aspirated and can be associated with both severe asphyxial forms and forms with insidious and vague symptoms which are difficult to diagnose correctly. A late diagnosis is however a fairly common event in literature. An anamnesis suggesting probable aspiration in a child under the age of 3 should direct doctors towards diagnostic and operative endoscope examinations of the patient, even where there is a negative clinical and radiological picture. Organic material, mainly peanuts, represented 60-75% of the findings, particularly in the 0-3 year age-band. In the other of cases inorganic material was extracted from school-age children. Aspiration of a FB exposes the patient to risk of serious complications and sequelae. Antibiotic, dexamethasone therapy and the ventilation support in the CPAP helped to avoid post-extractive sequelae. Prevention should in any case be the primary aim as regards to aspiration of foreign bodies in children. This should be stimulated by appropriate educational campaigns to raise awareness. The study included 62 child patients observed in the Department of Anesthesia and Intensive Care of the S.Orsola-Malpighi Hospital of Bologna over the last 11 years who were admitted for suspected FB aspiration.

Asphyxia↗
PubMed1993

Self-control expectancy and postsurgical pain: relationships to previous pain, behavior in past pain, familial pain tolerance models, and personality.

The importance of self-control expectancy on postsurgical pain was studied in 126 patients enrolled in a particular clinical setting. The contribution of previous pain experiences, past behaviors, vicarious experiences, and personality traits to self-control expectancy reported by patients was also investigated. To collect this information, a specific questionnaire and a semistructured interview were given before surgery. Minnesota Multiphasic Personality Inventory (MMPI), Eysenck Personality Inventory (EPI), and State-Trait Anxiety Inventory (STAI) personality tests were also administered. Postsurgical pain was assessed by measuring intensity (Visual Analogue Scale, VAS), latency (hr), and duration (days). Results show that expected emotional coping response is crucially related to the whole pain experience (intensity, latency, and duration). Self-control expectancy is associated with mastery behaviors in previous pains, vicarious experiences, and personality traits. These findings suggest that the knowledge of patients' beliefs about their ability to acquire and maintain control over impending pain is useful in predicting and managing postsurgical pain.

Adaptation, Psychological↗
PubMed1993

Individual pain history and familial pain tolerance models: relationships to post-surgical pain.

OBJECTIVES: (a) To investigate the influence of previous pain experience and familial pain tolerance models on postsurgical pain; (b) to investigate the effect of personality traits on vicarious learning. DESIGN: Before surgery, the patients completed the Minnesota Multiphasic Personality Inventory (MMPI), Eysenck Personality Inventory (EPI), and State-Trait Anxiety Inventory (STAI) personality tests. They also underwent a semi-structured interview to collect information on familial pain tolerance models and their own pain history. Postthoracotomy pain was assessed by measuring its latency (h), intensity (VAS 0-10), and duration (days). SETTING: A unique protocol to minimize the use of pain killers and encourage the adoption of coping strategies to face postsurgical pain was in use in the Thoracic Department. PATIENTS: A total of 126 patients who were free from chronic pain and undergoing thoracic surgery entered the study. OUTCOME: Most patients recalled a history of surgical or medical pain and good pain tolerance models in their original family. An almost equal number denied pain or had good pain tolerance models in their present family. Only a few patients reported poor tolerance models. RESULTS: Patients who had previously been subjected to medical pain experienced a greater intensity of pain. In addition, those who had reported poor tolerance in the original family experienced both earlier and more severe pain. Some patients' personality traits were related to familial pain tolerance models. CONCLUSIONS: We conclude that knowledge of an individual's pain history and familial pain tolerance models can be useful in predicting and managing post-surgical pain.

Adolescent↗
PubMedDate not supplied

[In-hospital pediatric cardiopulmonary resuscitation].

Between 0,7-3% of pediatric patients may require resuscitation during hospital stay. The physicians of the Pediatric Intensive Care Unit of the C.O.U. Anesthesia and Intensive Care-Baroncini developed a plan for the management of pediatric emergencies inside the Department of Pediatric Medical and Surgical Sciences. The plan consisted of: the drawing up of a PI 34-Procedure; the preparation and implementation of a training course for doctors and nurses; the purchase of 12 emergency-trolleys according to the Broselow Pediatric Resuscitation Measuring Tape and the implementation of a specific system for the emergency-call. Precise duty for anesthesiologists and intensivists is the emergency- planning and management, in order to diffuse the medical knowledge needed to assist patients requiring vital functions support. The management of the intra-hospital pediatric emergencies is strictly dependent on the training of the staff, based on a specific support algorithm, and specific equipment for the different ages.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

A pain educational program for pediatric nurses: topics and key points.

The undertreatment of pain in children may lead to severe consequences. Basic knowledge about pain in this category of patients may improve pain assessment and its management. In line with the Project established by the Italian Ministry of Health, authors planned an educational program devoted to the pediatric nurses. The concept of brain and of cognitive development, the methodological bases of the pain measurement and the cognition of long-term consequences on pain have been the key points of the program. The course was efficacious and highly appreciated by nurses. The improvement of practice standards will be the true indicator of its efficacy.

Adult↗
PubMedDate not supplied

Intensity, latency and duration of post-thoracotomy pain: relationship to personality traits.

The relationship between personality traits and post-surgical pain was studied in 126 patients submitted to a particular set of procedures. The personality was studied by MMPI, STAI, EPI tests before surgery. After surgery, pain intensity was positively related to duration, and pain latency negatively related to both intensity and duration. According to multiple regression analysis, pain intensity was found to be predictable from both the state anxiety and psychoasthenia scales, pain latency from state anxiety and masculinity/femininity, pain duration from aggressivity and hysteria. Results suggest that personality traits constitute strong modulatory factors of the overall pain experience.

Adolescent↗
PubMedDate not supplied

[Problems with anesthesia and intensive therapy in pheochromocytoma. A review of 25 cases].

A retrospective assessment is made of 25 cases of pheochromocytoma operated between 1970 and 1979. Three of the more complicated cases are discussed in detail. Actual and potential complications are described and a form of monitoring is proposed. The conclusion is expressed that correction of the pathological haemodynamic situation by expansion of the blood volume and the administration of alpha and beta blocking agents is of greater consequence in successful management than the anaesthesiological technique employed.

Adolescent↗