Anestesia subaracnoidea con levobupivacaina isobarica e fentanyl in chirurgia ortopedica

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[The role of the anesthesiologist in secondary hyperparathyroidism].

In the last years the increasing of diabetes and hypertension has produced a considerable increase of patients with chronic renal failure; secondary hyperparathyroidism is one of the major complications. The resection of hyperfunctioning parathyroid tissue is the ultimate goal of the treatment. The preoperative examination by the anesthetist is the starting-point of the treatment. The anesthetist programs hemodialysis, the correction of fluid and electrolyte abnormalities and of the anaemia. In the operating room the anesthetist is involved in the careful monitoring of liquid infusion and anesthesiological procedure. The intraoperative parathyroid hormone (PTH) assay is an essential tool be…

Terminal ligature of inferior thyroid arterhy branches during total thyroidectomy for multinodular goiter is associated with higher postoperative calcium and PTH levels

Purpose: To evaluate the impact of truncal versus terminal branch ligature of the inferior thyroid artery (ITA) on postoperative calcium and PTH plasma levels in patients undergoing total thyroidectomy for multinodular goiter. Methods: A prospective randomized study was performed comparing a group of patients that underwent either truncal ligature of the ITA (group 1) or terminal ligature of ITA branches (group 2). Results: A series of 126 consecutive patients with non-toxic euthyroid multinodular goiter underwent total thyroidectomy. Truncal ligature of the ITA was performed in 63 patients (group 1) and terminal branch ITA ligature in 63 patients (group 2). Postoperative ionized serum calc…

Comparison between local and regional anesthesia in arteriovenous fistula creation.

Purpose Assessment of the effectiveness of Brachial Plexus Block (BPB) via axillary approach compared to regional anesthesia for arteriovenous fistula surgery in patients affected by end-stage renal disease. Methods We compared forty patients randomly divided into two groups. Group A underwent BPB procedure with 15 mL ropivacaine 1% and 10 mL of saline (0.9% NaCl) via axillary approach. Group B received local anesthesia with lidocaine 2%. The forearm blood vessels were assessed by Doppler ultrasonography before and after the intervention. Results BPB performed on Group A was associated with a considerable venous dilation and a significant decrease (48.7%, P<.05) in pulsatility index (PI)…

Anestesia subaracnoidea con levopupivacaina isobarica e Fentanyl in chirurgia ortopedica

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La ligature terminale des branches de l’artère thyroïdienne inférieure diminue la morbidité parathyroïdienne après thyroïdectomie totale pour goitre

Resume But de l’etude Le but de cette etude etait d’evaluer l’impact de la ligature proximale de l’artere thyroidienne inferieure sur le taux postoperatoire de calcium et de parathormone chez les patients operes d’une thyroidectomie totale pour goitre. Patients et methodes Une etude randomisee a compare un groupe de patients operes par ligature proximale tronculaire de l’artere thyroidienne inferieure (groupe 1) a un deuxieme groupe de patients operes par ligature distale des branches de l’artere thyroidienne inferieure au contact de la capsule thyroidienne. Cent vingt-six patients consecutifs operes d’une thyroidectomie totale pour goitre multiheteronodulaire euthyroidien ont ete inclus. S…