[Intraoperative awareness: a true or false problem?]. / Il risveglio intraoperatorio: un problema vero o falso?

The authors base their remark on a few cases of awareness which have been reported in their hospital and on the history a patient who experienced intraoperative awareness during cesarean section. Attention is focused on the ethical, social and medico-legal aspects of this phenomenon. Awareness may severely affect the patient's psychic equilibrium with the consequent onset of severe neuroses leading to the possibility of legal action and claims for compensation. Clinical experience has shown that the use of halogenate anesthetics, even in low concentrations, may help to avoid this phenomenon. Correct relations between the anesthetist and patient before and after surgery may also, even in the event of awareness, reduce the incidence and severity of consequent psychological sequelae.

[EEG in the diagnosis of brain death. A rare bioelectrical artifact]. / L'EEG nella diagnosi di morte cerebrale. Un raro artefatto bioelettrico.

The Authors, starting from a clinical observation of brain death, demonstrate that an EEG tracing can undergo some modifications which are linked to the flask distension of the endotracheal tube. In fact, when there is a passage of air between the wall of the tube and the wall of the windpipe passage that we have when the flask is not adequately full of air, we get some bioelectrical modifications. This kind of modifications influence the tracing itself and they are also able to engender the suspicious of a renewal of cerebral activity.

[Operative risk. Patient evaluation, informed consent]. / Rischio operatorio. Valutazione del paziente, consenso informato.

It is mandatory, the Authors say, to obtain a previous and definite consent before the patient undergoes the operation. Moreover the patient shall be well acquainted about the risk connected to the operation before he gives his consent. On the contrary, as already confirmed by the Italian Supreme Court of Justice, the consent shall not be valid and the Doctors could be found guilty of "psychic violence". Finally the Authors, to evaluate the probable risks liked to the operation, use scales as ASA and prognostic indexes as SAPS to avoid appraisage too subjective.