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Εταιρεία Αναισθησιολογίας και Εντατικής Ιατρικής Βορείου Ελλάδας (ΕΑΕΙΒΕ)
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Ελληνική Αναισθησιολογική Εταιρεία

Αγαπητοί συνάδελφοι,

Στα τέλη του 2010, το διοικητικό συμβούλιο της Ε.Α.Ε.Ι.Β.Ε. μου ανέθεσε την ευθύνη της σύνταξης του περιοδικού “ΗΛΕΚΤΡΟΝΙΚΟ ΠΕΡΙΟΔΙΚΟ ΠΕΡΙΕΓΧΕΙΡΗΤΙΚΗΣ ΙΑΤΡΙΚΗΣ” - ejournal. Με μεγάλη χαρά αποδέχθηκα την τιμή και με την ευκαιρία αυτής της επιστολής σας ευχαριστώ όλους (διοικητικό συμβούλιο, μέλη και αναγνώστες του περιοδικού) θερμά.

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A lot of techniques have been tested for their potential to salvage myocardial tissue during an episode of acute ischaemia. Techniques that are applied before the onset of acute ischaemia, i.e. preconditioning techniques, have proved to be really protective, but scheduled ischaemia or at least high probability for the timing of it’s occurrence, is a pre-requisite for their application. This disadvantage led to experimentation on techniques that can be applied immediately after the onset of acute ischaemia or at least on the time of reperfusion.

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The issue of cerebral circulation and oxygen delivery to the brain requires constant vigilance for the clinician in the ICU, the trauma unit and the neurosurgical operation suite. These patients are administered anaesthetic medications that affect cerebral physiology by a lot of different and some times unexplored mechanisms.

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This article aims at presenting the anesthetic and surgical techniques used to preserve spinal cord integrity during thoracoabdominal aortic aneurysm (ΤΑΑΑ – ThoracoAbdominal Aortic Aneurysm) repair operations.

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The tremendous impact of hypoxia on any critical organ, namely the brain and the heart, are well known, at least because of their obvious result. The question asked by many: “For how long can the patient tolerate apnoea?” cannot be answered with certainty for any given patient. The long list of possible problems that may arise during the transport of O2 from the anesthetic circuit to the very last cell of the human organism precludes any possibility of precise calculation. Hypoxia of critical tissues (the brain and the heart) has deleterious pathophysiologic effects on them.

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Since the advent of clinical anesthesia, there has been a continuous need for evaluating the depth of anesthesia. Depth of anesthesia was always important in avoiding either overdose (toxicity) or “underdose” (administering less than absolutely necessary). The problem of overdosing has been partly solved by assignment of dedicated and specially trained doctors to provide anesthesia services, by accumulating more than a 100 years of experience in administering anesthesia, by using safer drugs (volatile and intravenous) with extremely smaller toxicity than the older ones and by recognizing and establishing the stages of anesthesia (such as Guedel stages) and the hemodynamic parameters as indirect but useful indices of the depth of anesthesia. The current trend of minimizing expenses of anesthesia calls for tight titration of drug administration.

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We present a case of severe postoperative negative pressure pulmonary edema (NPPE) in a young male patient scheduled for elective surgery. During recovery from anesthesia the patient got agitated, bit the laryngeal mask persistently and made forceful inspiratory efforts.

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