Anaesthetics modulate tumour necrosis factor α: effects of L-carnitine supplementation in surgical patients. Preliminary results.

Both anaesthetics and surgical trauma could strongly affect the production of tumour necrosis factor α (TNFα). During in vitro experiments the authors found that anaesthetics modulate the production of TNFα by peripheral blood mononuclear cells. Notably, Pentothal strongly increased the production of the cytokine as compared to both lipopolysacchride treated and control mononuclear cells, whereas in supernatants from Leptofen driven mononuclear cells TNFα was strongly reduced. On the other hand, Pavulon did not significantly affect the cytokine production. In the in vivo study, in an attempt to ameliorate the metabolic response to surgical trauma, L-carnitine was administered to 20 surgical patients, then the circulating TNFα was measured. The results indicate that the levels of circulating TNFα were strongly increased following surgery and that L-carnitine administration resulted in a strong reduction of TNFα. Thus, the data suggest that L-carnitine could be helpful in protecting surgical patients against dysmetabolism dependent on dysregulated production of TNFα

Modificazioni della temperatura rilevata in sedi diverse durante colicistectomie laparoscopiche

Il controllo termico profondo,divenuto molto più facile per il progresso tecnologico,si rileva utile in molti campi chirurgici.Normalmente in corso di intervento chirurgico si osserva una ipotecnica laparoscopica i nostri controlli hanno diversi fattori

[The use of propofol for sedation in endoscopic procedures].

The authors illustrate different endoscopic procedures that may require anaesthesiological assistance through analgo-sedation procedures. Analgo-sedation is useful to the patient and to the endoscopist that can carry out the exam more rapidly and in optimal conditions. The technique employed consists in the administration of propophol, starting with an initial bolus of the drug followed by a continuous perfusion to maintain the hypnotic state. Monitoring of cardiovascular and respiratory parameters shows a great reliability of the drug and effectiveness of the method

Modificazioni Emogasalitiche e Glicemiche dopo infusione e.v. rapida di soluzioni diverse in soggetti normali,realizzate in fase preoperatoria

Pur ritenendo che la fluidoterapia endovenosa sia uno dei fattori del successo in molti tipi di chirurgia, gli autori,espongono i risultati di una ricerca condotta su 15 pazienti, volta a verificare le modificazioni dello stato acido-base,della glicemia e di alcuni parametri circolatori dopo infusione rapida di soluzioni di cloruro di sodio 0,9%,di glucosio e di fruttosio 5%

Tempi di comparsa dell'effetto provocato e tempi di recupero dopo somministrazione e.v. di tre diversi Miorilassanti non depolarizzanti ( valutazione clinico -strumentale)

Gli autori hanno studiato con la tecnica dello stimolo singolo i tempi di comparsa e i tempi di ripresa della trasmissione neuromuscolare utilizzando il nervo ulnare ed il muscolo adduttore breve del pollice in 45 pazienti divisi in 3 gruppi e trattati con d-tubocurarina,pancuronio e vecuronio

[Clinical evaluation of the efficacy of Ro 15-1788, Anexate after balanced intravenous anesthesia with flunitrazepam and fentanyl].

Benzodiazepines are widely used as neuroleptics in anaesthesia, but they give rise to drowsiness at the end of surgery. Anexate is an imidazobenzodiazepine with specific antagonistic activity for benzodiazepines. We have administered 0.2 mg i.v. of the drug to 20 adult patients after anaesthesia with tiopentale (250 mg), pancuronium bromide (0.07 mg.kg-1), flunitrazepam (2 mg) and fentanyl (0.10 mg); after the first dose fentanyl was administered (0.10 mg) about every 30 minute. Analgesia was supplemented with nitrous oxide 66%. Blood pressure and heart rate did not changes significantly after Anexate; respiratory volume increased significantly in all cases (ANOVA P less than 0.001). Consciousness was rapidly resumed in all cases and patients demonstrated to be oriented in time and space soon after Anexate. In 14 out of 20 patients drowsiness reappeared after about 30 minute and further doses of 0.1 mg of the drug (to a maximum of 0.4 mg in some cases) were necessary. Side effects were rare and slight, their occurrence depending on the speed of administration. In our opinion a total dose of 0.3 to 0.4 mg Anexate is need to fully antagonize the sedative effect of 2 mg flunitrazepam

Modificazioni di alcuni parametri cardiorespiratori indotte dal Salbutamolo al termine di interventi di Chirurgia Generale

Dopo aver brevemente ricordato le acquisizioni fisiologiche relative ai vari tipi di recettori del sistema adrenergico e i conseguenti progressi in campo farmacologico per la stimolazione o il blocco selettivo di alcuni di essi, gli autori espongono le modificazioni di alcuni parametri cardiorespiratori dopo somministrazione di salbutamolo durante anestesia con alotano o etrano,dopo iniezione di prostigminaed atropina

The use of di-hydroxypropylphenol (Propophol) in endoscopic procedures

The authors illustrate different endoscopic procedures that may require anaesthesiological assistance through analgo-sedation procedures. Analgo- sedation is useful to the patient and to the endoscopist that can carry out the exam more rapidly and in optimal conditions. The technique employed consists in the administration of propophol, starting with an initial bolus of the drug followed by a continuous perfusion to maintain the hypnotic state. Monitoring of cardiovascular and respiratory parameters shows a great reliability of the drug and effectiveness of the method

Status Epilepticus in Critically Ill Patients

Status epilepticus (SE) is a common diagnosis in critically ill patients that may bear significant morbidity and mortality. Nowadays it is defined as continuous seizure activity lasting for more than 5 mins and requiring a specific treatment. A generalised convulsive state is a medical emergency burdened by high mortality, especially in the elderly, because repeated seizures swiftly induce significant metabolic and cardiocirculatory derangement. Two different kinds of SE are commonly recognised, depending on the presence of convulsion: convulsive SE and non-convulsive SE, which have different electroencephalographic patterns and require different therapies. In this review we provide an overview of this intriguing issue, focussing on critically ill patients