Search results for "ANESTHESIA"

ESRA19-0278 Sufentanil sublingual tablet system (SSTS) in post-operative pain: a case series

2019

Background and aims SSTS is a preprogrammed, non invasive, patient-activated bed-side system that enables patients to manage moderate-severe acute pain in a hospital setting. Our aim is to evaluate efficacy, ease of use of SSTS, patients and nurses’ satisfaction. Methods We evaluate pain control and general satisfaction in patients treated with SSTS after general or orthopedic prosthetic surgery. Enrollment started on April the 1st at Policlinico Paolo Giaccone in Palermo and is still ongoing. SSTS allows patients to self-administer a 15-μg sufentanil tablet sublingually with a 20-minute lockout, up to 72 hours. We visit patients three times per day, recording pain control (NRS scale), arte…

Regional Lung Blood Perfusion Measured With Laser Doppler Method During Body Position Change, Valsalva Manoeuvre and Cardiopulmonary Bypass

2008

Regional Lung Blood Perfusion Measured With Laser Doppler Method During Body Position Change, Valsalva Manoeuvre and Cardiopulmonary Bypass Methodological approaches to investigate local regulatory mechanisms of lung blood supply in humans are restricted. We tried a new approach using laser Doppler technique. During bronchoscopy, an angled laser Doppler flow probe was introduced through a biopsy channel and wedged into small bronchus. Laser light penetrated the wall of small bronchus and was reflected from blood cells running through neighbouring capillaries. Regional blood perfusion changes were recorded during body position change from vertical to supine and back to vertical, while perfor…

Inspired supplemental oxygen reduces markers of oxidative stress during elective colon surgery.

2007

.Anaesthesia was induced with sodium thiopental andfentanyl, and maintained with sevoflurane. After inductionof anaesthesia, patients were randomly assigned 30 or80 per cent oxygen throughout surgery and for 6 hafterwards. During surgery, lungs were ventilated involume-controlled mode (10 ml/kg), whereas during the6 h afterwards respiration was spontaneous with an oxygenmask (16 l/min)

Chirurgie der kindlichen Nebenniere. Operationstaktik, intra- und perioperative Überwachung

1988

Surgical and non-surgical conditions of the adrenal cortex and medulla are presented. Besides general principles of operative treatment (e.g. surgical approach, safe operative technique, bilateral exploration) specific aspects associated with this procedure in childhood are discussed. The perioperative management and pharmacotherapeutical preparation (e.g. hormonal substitution) are emphasized.

Transmission of arterial oxygen partial pressure oscillations to the cerebral microcirculation in a porcine model of acute lung injury caused by cycl…

2013

Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI) leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa(O(2))). These Pa(O(2)) oscillations could also be forwarded to the cerebral microcirculation.In 12 pigs, partial pressure of oxygen was measured in the thoracic aorta (Pa(O(2))) and subcortical cerebral tissue (Pbr(O(2))). Cerebral cortical haemoglobin oxygen saturation (Sbr(O(2))), cerebral blood flow (CBF), and peripheral haemoglobin saturation (Sp(O(2))) were assessed by spectroscopy and laser Doppler flowmetry. Measurements at different fractions of inspired oxygen (F(I(O(2)))) were performed …

The influence of the C1-inhibitor BERINERT® and the protein-free haemodialysate ACTIHAEMYL20%® on the evolution of the depth of scald burns in a porc…

1997

Standardized deep partial-thickness burns were inflicted on domestic pigs by scalding 30 per cent of the skin surface for 25 s with 75 degrees C hot water. The animals (n = 18; weight 25-35 kg) were divided into three groups: I, control group (n = 6), Ringer's lactate only; II, haemodialysate group (n = 6), Ringer's lactate and a protein-free haemodialysate of calf-blood (ACTIHAEMYL20%; AH) and III, C1-inhibitor group (n = 6), Ringer's lactate and C1-inhibitor (C1-INH; BERINERT). Skin biopsies were taken at defined time points (4, 28, 52 and 76 h) and investigated histologically. Depth of burn was determined morphometrically after coloration with a modified MTT-staining on frozen sections o…

Metabolic adaptation and neuroprotection differ in the retina and choroid in a piglet model of acute postnatal hypoxia.

2013

Hypoxic-ischemic insults to the neonatal brain may cause neurodevelopmental disorders. Vulnerability of different areas of the neural tissue to hypoxic-ischemic stress might be explained by either heterogeneous sensitivity to oxygen or neuroprotective capability. Our understanding of regional heterogeneity is still incomplete in terms of metabolic reconfiguration and/or activation of neuroprotective mechanisms.We studied, by western blotting, reverse-transcriptase PCR, and tandem mass spectrometry, the response of retina and choroid at protein, gene, and metabolic levels during hypoxia in a piglet model of acute postnatal hypoxia.We evidenced a metabolic shift towards glycolysis in choroid …

0110 : Experimental cerebral ischemia in rats increases myocardial vulnerability to ischemia-reperfusion injury ex vivo

2016

For years, the relationship between cardiac and neurological ischemic events has been mainly attributed to overlapping pathophysiological mechanisms and common risk factors. However, acute stroke may induce dramatic alterations of cardiovascular function. The aim of this work was to evaluate how prior cerebrovascular lesions affect myocardial function in vivo and ex vivo , as well as myocardial vulnerability to ischemic injury. Cerebral embolization was performed in adult Wistar male rats by the injection of microspheres into the left internal carotid artery. Left ventricular function, investigated in vivo using echocardiography (1 hour, 24 hours and 7 days after the embolization), was not …

The anesthesiologist and end-of-life care

2012

Purpose of review Anesthesiologists may face problematic situations when patients are close to death, in which clinical problems, decision-making processes, and ethical issues are often interconnected and dependent on each of them. The aim of this review is to assess the recent literature regarding the anesthesiological role for advanced cancer patients. Recent findings Palliative sedation in the dying patients, end-of-life problems in the ICU, and pain control in advanced cancer patients have been the subject of recent research. All these issues have shown that anesthesiologist would be expert in the field of pain and symptom control at the end of life. End-of-life care problems are common…

2019

Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two different intraoperative m…