How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Antioxidant property of Propofol in the ischemic and reperfused human skeletal muscle

Background. Oxygen-derived free radicals (ROS) are involved in tissue damage during muscle ischemia and reperfusion. Recent in vitro studies have demonstrated that a beneficial effect of Propofol (2,6 diisopropylphenol) lies on its free radical scavenging properties. The current study therefore examined whether Propofol is effective against the peroxidative damage induced by ROS in human skeletal muscle in the course of acute ischemia and reperfusion. Methods. A homogeneous group of patients (n=20) undergoing orthopedic surgery was subjected to handline tourniquet at 350 At for 60 min following by 20 min postischemic reperfusion. In skeletal muscle samples (m. vastus lat.) malondyaldeide (MDA), catalase (CAT) and uric acid levels were analyzed before tourniquet application, after 60 min of ischemia and then after 20 min following reperfusion. To ten subjects Propofol was supplied as bolus (5 mg/kg, body weight) during the ischemic interval. The tissue concentrations of MDA, CAT and Uric Acid were measured by spectrophotometric and phluorimetric methods comparing the values with the data obtained in an untreated group of patients (n = 10). Results. In all patients ischemic injury significantly increased MDA, and Uric Acid contents with a concomitant decrease in CAT levels. When reperfused the Propofol treated group showed an evident decrease in MDA Uric, and CAT gradients in respect of ischemic tissue. On the contrary rapid reoxygenation implies a highly significant increase in MDA as far as Uric Acid contents, while Catalase levels were unchanged. Conclusions. The current study demonstrated that in the human skeletal muscle Propofol attenuates the lipid peroxidation induced by ischemia and reperfusion and this beneficial action of Propofol is probably correlated with the free radical scavenging properties of this molecule