A significant number of patients exhibit impairment in cognitive function immediately following surgery or later; the impact of this postoperative cognitive dysfunction on the recovery and quality of life of the patient but also on the necessity for supportive and rehabilitation care is important. Risk factors for postoperative cognitive impairment and postoperative delirium have been described and it is these groups of patients that require early identification and careful follow up to avoid complications in postoperative care.
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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.
Continue readingGeneral anaesthesia is associated with a reduction in heart rate variability (HRV) compared to awake situation. In this study the hypothesis of reduction in HRV was tested in two different levels of anaesthesia depth. Forty six patients were randomly allocated in two groups, where anaesthesia was maintained with sevoflurane (n=23) or propofol (n=23). Administration of both anaesthetics was regulated in order to achieve a BIS value 25±5, followed by an increase to 55±5, both being stable for 5 min.
Continue readingIn order to evaluate the postoperative analgesic effect of caudal administration of levobupivacaine, plain or in combination with neostigmine, 50 children who underwent medium gravity operations were studied. The children were randomly divided into two groups: Group L received 1 ml/kg of levobupivacaine 0.25% solution via caudal route, while in Group LN the same solution plus 2 μg/kg neostigmine was given.
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Pulmonary capillary pressure (Pcp) is the primary driving force determining the fluid flux across pulmonary capillary wall. Alterations of Pcp have been described in systemic inflammation, sepsis, ARDS, hypoxaemia and acute heart failure. The purpose of this study was to examine the Pcp alterations after lipopolysaccharide (LPS) intravenous administration in pigs. LPS has been administered (150μg/Kg BW) in the right atrium of 8 anesthetized and mechanical ventilated pigs (Group A) and the Pcp was calculated from pulmonary artery pressure tracings using the Gaar equation before, after LPS infusion and in 20min intervals for two hours.
Continue readingAs general anaesthesia administered during the first two trimesters of pregnancy for gynaecological procedures was associated with a high incidence of mis-carriage and exposes the fetus to teratogenic effects of drugs, a case of successful breast tumour extraction under thoracic paravertebral block is reported with review of the literature.
Continue readingΒασική Υπερηχοκαρδιoγραφία: Στοιχειώδεις μετρήσεις και φυσιολογικές τιμές
Pathophysiology of hypoxia during apnoea. A short review
Current issues concerning coagulation disorders in severe sepsis and multiple trauma patients
Impact of haemodynamic alterations on arterial blood gases during off-pump coronary revascularization
Colloids vs crystalloids as prehydration regimen before spinal anaesthesia in elderly normotensive and hypertensive patients
Anterior approach to celiac plexus block using CT Guidance
Echocardiography has a predominant role in the diagnosis of many clinical questions perioperatively. The techniques for i) measurement of the most important anatomic dimensions and ii) for calculations of the basic normal and functional values are briefly described. The advantages and limitations of each method are also mentioned.
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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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Perturbations of the clotting system frequently accompany systemic inflammatory states. Coagulation abnormalities, specifically an imbalance between coagulant and anticoagulant mechanisms, are a frequent occurrence in patients with septic shock and trauma and have been associated with an increased mortality.
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