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Biomedical subjects

V Moschini

Publications and source records attributed to V Moschini.

12 recordsLinked to original sources
PubMed2003

The role of the pain therapist in the approach to chronic headache.

Chronic daily headache (CDH) represents, for the anesthesiologists, a big match in the management of a pain which is simultaneously central and periferic, of a pain wich is psychical and disabiliting. This is a pain conducting the patient to overuse analgesic medicaments even making worse "allodynia" and the organic integrity. That's why a multidisciplinary approach to this kind of chronic benign pathology permits to improve prognosis and quality of life.

Analgesics↗
PubMed2001

[Cataract surgery: regional anesthesia or monitored anesthesia care?].

BACKGROUND: Retrospective study in patients undergoing cataract surgery by facoemulsification in order to evaluate the incidence of regional peribulbar anaesthesia compared with MAC (Monitored Anesthesia Care). METHODS: Between January 1999 and December 2000, 1902 patients were studied. Peribulbar anaesthesia was performed by using a double or single inferior-lateral injection with a mixture of Lidocaine 2% and Bupivacaine 0.5% or, as a single agent, of Ropivacaine 0.75%. Jaluronydase 10 UI/ml was added to either agents. RESULTS: Only in 8% of patients intravenous drugs were added during surgery to correct bradycardia in 3%, hypertension 3% and for sedation in 2%. CONCLUSIONS: Regional anesthesia represents the most suitable anesthesia technique in patients undergoing cataract surgery by facoemulsification. Only in 8% of patients MAC was suitable, due to excessive anxiety or cardiovascular imbalance. Compared to other anesthesia techniques, regional anaesthesia is significantly safer. The utility of preoperative tests in reducing the morbidity associated with surgery, is also discussed.

Aged↗
PubMed2000

[Anesthesiologic considerations in Cornelia de Lange syndrome].

BACKGROUND: Retrospective study in pediatric patients with Cornelia de Lange syndrome undergoing different surgical operations, in order to critically evaluate the anesthesiologic aspects of this syndrome. METHODS: Between January 1997 and December 1998, 42 patients undergoing diagnostic examinations (esophagogastroscopy, oculistic visit) or surgery (total exodontia, fundoplicatio for esophageal reflux, correction of labiopalatoschisis) have been studied. The anaesthesiologic technique has been similar for all the cases. RESULTS: Any particular difficulty or inconvenience in comparison with patients with the same range of age, or particular intraoperative difficulties have been observed. In only one patient the McCoy laryngoscope was used due to difficult intubation (Cormack and Lehane III). CONCLUSIONS: Short neck, ogive palatum, cleft palate, micrognatia, urogenital and gastroenteric anomalies, esophageal reflux, together with heart defects (15% of cases), can complicate the peri and postoperative period in these patients. A careful preoperative evaluation and a careful perioperative management, may decrease anesthetic complications in Cornelia de Lange syndrome to the same range of normal patients.

Abnormalities, Multiple↗
PubMed1999

[The use of bronchial fibroscopy for difficult intubations in maxillofacial surgery].

BACKGROUND: Evaluation of difficulties and modalities of tracheal intubation in maxillofacial surgery. METHODS DESIGN: retrospective study. SETTING: maxillofacial operation room. 2152 patients who underwent elective maxillofacial surgery during a five-year time, from 1994 to 1998. Indications and alternative modalities of tracheal intubation through fiberoptic bronchoscope in eight patients (0.37%) with preoperatively evaluated difficult intubation due to temporomandibular ankylosis (3 patients), burns sequelae (1 patient), craniofacial congenital malformations (2 patients), unstables fractures of the cervical spine (2 patients), are discussed. Fiberoptic bronchoscope was used through nasotracheal route under topical nasal and laryngeal anaesthesia, combined with appropriate benzoanalgesia, in order to maintain spontaneous breathing. Proper positioning of tracheal tube was directly checked by fiberoptic bronchoscope, through visualization of the tracheal carina. RESULTS: In seven patients tracheal intubation was easily performed without complications in less than 20 minutes. In the eight patients the time spent was 35 minutes, due to important nasal bleeding, which caused a change of the nostril. CONCLUSION: Among the alternative methods of elective tracheal intubation, previously evaluated as difficult or impossible using conventional laryngoscopy, the use of fiberoptic bronchoscope seems to be safest and easiest to use, although not the cheapest.

Adult↗
PubMed1996

[The phantom breast syndrome].

BACKGROUND: The phantom breast syndrome (PBS) is a complication of mastectomy which consists of a sensation of breast persistence after mastectomy. MATERIALS, PATIENTS AND METHODS: The incidence, clinical course and location of PBS in 97 operated women were studied for a 15-year period. All women were interviewed in postoperative follow-up controls after mastectomy. RESULTS: The incidence of PBS was 29 patients out of the 97 total. The syndrome was present for more than 48 months in eleven of these patients. In most cases the location of "phantom sensations" was the nipple (15 cases) and the entire breast in five patients. In only three patients was phantom breast pain (PBP) reported whereas some discomfort was reported by the other patients. CONCLUSIONS: The incidence of PBS in our series was similar to that reported by other authors, but PBP was less common. Neither postoperative sequelae nor the antitumoral specific therapy seemed to have influence on the emergence of PBS.

Adult↗
PubMed1995

[Anesthesia in hypertrophic pyloric stenosis].

Hypertrophic pyloric stenosis is one of the most common gastrointestinal abnormalities occurring in the first six months of life. It is a medical emergency and surgical therapy is considered only after correction of fluid and electrolyte deficits. Careful preoperative therapy to correct deficits may require several days to ensure safe general anaesthesia and surgery. The anaesthetic management of 58 consecutive infants (51 male, 7 female) with congenital hypertrophic pyloric stenosis over a 4-year period is reviewed. Mean age was 39.5 days (range 13-100), mean weight was 3.95 kg (range 2.4-5.3). Elective Ramstadt's fibromyotomy was performed after water-electrolyte balance restoration. Inhalation induction was made and oro-tracheal intubation achieved with succinylcholine 1.5 mg/kg-1. General anaesthesia was performed without complications. All patients were discharged during the period between the 2nd and 7th day after surgery, except one who was discharged after 16 days because of dehiscence of the surgical wall. Preoperative preparation is the primary factor contributing to the low perioperative complication rates, and the necessity to recognize fluid and electrolyte imbalance is the key for a successful anaesthetic management.

Anesthesia, Inhalation↗
PubMed1990

Pattern reversal visual evoked potentials (VEP-PR) in migraine subjects with visual aura.

Twenty patients with migraine with visual aura, aged 19 to 55 years (2 men and 18 women) were studied by the method of Visual Evoked Potentials (VEP). The control group consisted of an equal number of healthy subjects, comparable for age and sex. The most important finding in our study is that migraine patients with visual prodromata have a significantly longer P100 latency than the subjects of control group. These modifications of the VEP-PR could indicate, as other investigators have pointed out, that there are some special metabolic conditions and abnormalities of neuromediators during and between attacks.

Adult↗
PubMedDate not supplied

Complications of epidural and combined spinal-epidural analgesia in labour.

AIM: The practice of relieving pain during childbirth with epidural or combined spinal-epidural analgesia is very widespread in the major Western countries, and is increasing in Italy. There are, however, numerous complications of this practice for both the woman and the mechanism of the labour. The aim of our study was to evaluate the short and long term complications of these techniques in a randomised sample of women. METHODS: A randomised, longitudinal, retrospective study was carried out in a sample of caucasian nulliparous women who gave birth in the second half of 2001. The subjects were divided into 3 groups: Group 1, women who gave birth with the aid of epidural analgesia; Group 2, women who received combined spinal-epidural analgesia during labour; Group 3, women who delivered without any analgesia. The short and long term complications of the 2 analgesic techniques were compared with those occurring in the control group, using Fisher's exact test. RESULTS: The frequency of at least one unwanted effect was higher in the 2 groups of women who received analgesia than in the control group. Hypotension and pruritus were statistically significantly more frequent in the group receiving spinal-epidural analgesia than in the other 2 groups. There were no statistically significant differences between the 3 groups in the rates of late complications or incidence of deliveries completed by cesarean section. CONCLUSIONS: The short-term complications of the analgesic techniques used during labour were not very relevant with respect to the subjects' satisfaction (excellent in 66% of the women in the group managed with epidural analgesia and 73% among those treated with the combined spinal-epidural technique). There was not a statistically significant difference in the percentage of cesarean deliveries in the 3 groups. Epidural and spinal-epidural analgesia to relieve pain during labour can, therefore, be considered safe and reliable.

Adult↗