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Biomedical subjects

N Stocchetti

Publications and source records attributed to N Stocchetti.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Control of the side effects of ketamine: chlordemethyldiazepam vs diazepam in pre-anesthesia].

The pre-operative circulatory and psychotomimetic side-effects are studied in one hundred patients undergoing elective plastic-reconstructive surgery and anesthetized by ketamine 5-8 mg/kg i.m. Fifty patients were premedicated by atropine 0.01 mg/kg + CDDz 0.0285 mg/kg i.m. (group C), fifty by atropine 0.01 mg/kg + Dz 0.14 mg/kg i.m. (group D). All patients breathed spontaneously. Statistical analysis was performed with X 2 test. Not statistical difference was observed for the circulatory side-effects, whereas the frequency of emergence phenomena fell significantly from 31% to 14% (p less than 0.05) with CDDZ in greater than 16 years old patients. These finding seem confirm that CDDZ is more effective than DZ in reducing the psychotomimetic side-effects of ketamine, though it may be recommended a its wider experiment in this connection.

Adolescent↗
PubMed1987

[Chlordesmethyldiazepam as an anesthesia-inducing agent: time of loss of consciousness. Statistical analysis in man].

.1 mg/kg e.v. of chlordesmethyldiazepam, a 1.4 benzodiazepine derivative, were given in induction of anaesthesia of 60 plastic-reconstructive surgery patients respectively in 30 (Group 1.30 patients) and in 60 sec (Group 2.30 patients) to assess the times to spontaneous closing of the eyes and to disappearance of the palpebral reflex. It is concluded that the reflex times are not significantly different in both groups.

Adult↗
PubMed1986

[Anesthesiologic management in scleroderma patients. Presentation of a clinical case].

The scleroderma (literally, hard skin), or progressive systemic sclerosis (PSS), is a multisystem disease and can present various anaesthetic problems. The anaesthesist should be aware of the difficulty in opening mouth wide enough for laryngoscopy and intubation, the possibility that cardiopulmonary changes may be present and the probability of lesions in oesophagus, bowel, kidneys, skin and joints. In this article the authors describe the anesthetic management of a patient with Thibierge-Weissenbach syndrome (scleroderma with calcinosis cutis) and explore potential problems that should be anticipated by the anesthesiologist.

Anesthesia↗
PubMedDate not supplied

Propofol 1% and propofol 2% are equally effective and well tolerated during anaesthesia of patients undergoing elective craniotomy for neurosurgical procedures.

BACKGROUND: The 2% formulation of the intravenous anaesthetic agent, propofol (Diprivan), delivers half the amount of lipid compared with the original 1% formulation. This may provide an acceptable alternative for patients who have an impaired ability to metabolise lipids. METHODS: This study was a multicentre, randomised, open comparison of parallel groups. Seventy-three adult patients undergoing elective craniotomy in neurosurgery were randomised to receive either propofol 1% (10 mg/ml) or propofol 2% (20 mg/ml) for induction and maintenance of anaesthesia. RESULTS: Analysis of induction time (199 s, 1%; 202 s, 2%; p > 0.05) and induction dose (1.13 mg/kg, 1.12 mg/kg; p > 0.05) shows that propofol 1% and propofol 2% are pharmacodynamically equivalent. Both formulations were similar regarding overall administration rates, recovery times, haemodynamic variables and tolerability. Plasma triglyceride levels, were lower in the propofol 2% group compared with the propofol 1% group, and significantly lower (p < 0.05) from 1 to 4 hours after induction. CONCLUSIONS: We conclude that propofol 2% is as effective and as well-tolerated as propofol 1% for anaesthesia and is an acceptable alternative to propofol 1% in patients undergoing elective craniotomy in neurosurgery. The lower lipid load suggests it may be of particular benefit to patients with disorders of lipid metabolism.

Adult↗
PubMedDate not supplied

[Cerebral perfusion pressure in endocranial hypertension in comatose head-injured patients].

The aim of the intensive care of the injured is the coupling of the availability and the requirement of the cerebral metabolic substates. The measurement of the cerebral blood flow is not currently available at the bedside and less direct monitoring is required. The cerebral perfusion can be estimated looking at the cerebral perfusion pressure (CPP), that can be easily measured using intracranial pressure (ICP) and the systemic arterial pressure (MAP) monitoring. Hundred-twenty-one consecutive head injured admitted to an Intensive Care Unit were studied assessing the severity of the neurological injury, the CT-Scan diagnosis of the intracranial lesion, the Trauma Score and the behavior of the ICP and MAP. The outcome was classified according to a modified version of the Glasgow Outcome Scale. More than 77% of the patients suffered raised intracranial pressure above 20 mmHg and 16 of them had a CPP less than 60 mmHg for more than 5 minutes. The outcome was directly related to the degree of intracranial hypertension and to the severity of insufficient CPP. The treatment of the severe head injured must be aimed at maintaining a good CPP, because of the close relationships between this value and the prognostic result. The monitoring of the ICP is a reliable and relatively safe procedure in this series, where the rate of infections complicating the intracranial recording is less than 3%.

Adolescent↗
PubMedDate not supplied

[Clinical use of cerebral elastance and intracranial dynamics measurements].

The treatment of Intracranial Pressure (ICP) requires not only the determination of the pressure but also some kind of estimate of the relationship between intracranial volume and actual pressure. The measurement of the Pressure Volume Index (PVI) offers a quantitative assessment of such a relationship, provided that the measurement is safe and accurate. In 98 comatose patients admitted to the Intensive Care Unit for the treatment of head injury or subarachnoid hemorrhage the ICP was continuously recorded using ventricular or subdural catheters. In 68 patients the PVI was measured using the bolus technique every 12 hours; the intracranial dynamics was assessed according to Marmarou's equations. The preliminary part of the work reviewed the methodology: the interobserver variability was studied and the differences between the PVI data obtained through addition or withdrawal of fluid were determined. The data obtained by different observers did not differ substantially, due to the clear establishment of rules for the measurement. The PVI data obtained withdrawing fluid were lower than the data produced adding volume but the mean PVI calculated after 6 bolus changes of the intraventricular volume reached a good correlation coefficient (> 0.8) with all the measurements. After that the clinical use of the PVI was tested. The patients with a PVI lower than 15 ml showed an increased risk of developing intracranial hypertension in the first 72 hours after trauma of SAH. The group of patients with an intracranial compliance lower than 0.5 had a mortality rate of 27.3%, compared with the rate of 14.3% showed by the patients with a greater Compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗