[Monitoring of cuff pressure in double-lumen endotracheal tubes during anesthesia for thoracic surgery]. / Il monitoraggio della pressione di cuffia in tubi endotracheali a doppio lume durante anestesia per chirurgia toracica.

It is well known that cuff overinflation in endotracheal tubes may cause serious damage to the tracheal mucosa. Cuff overinflation is also related to the diffusion of nitrous oxide across the cuff membrane, thus giving way to a progressive volume/pressure increase up to overcoming, critical capillaric perfusion pressure. The kinetics of hi-lo cuff-pressure in single-lumen endotracheal tubes during general anesthesia using nitrous oxide has been well documented. The authors have investigated the cuff-pressure modifications in 40 left double-lumen tubes (DLTs), monitoring the inflation pressure for both the endotracheal and endobronchial cuffs at the sealing of the airways and at different phases of the anesthetic procedures performed using nitrous oxide, in 40 male patients undergoing thoracic surgery. In ten of these case, special equipment was used in order to keep the cuff-pressures steady and at the lowest sealing level. The pressure shows the same trend in both cuffs but, depending on the medium calibre of the main left bronchus and the volume/pressure relations of the endobronchial cuffs, the pressure in the latter increases faster. The investigation was performed using an original equipment developed by the authors; such equipment is able not only to monitor the cuff-pressures, but also to maintain them at steady controlled levels (below 20 cm water seal), by means of counterregulating all the volume variations due either to anesthetic requirements, or to the diffusion of nitrous oxide.(ABSTRACT TRUNCATED AT 250 WORDS)

[Idiopathic long QT-syndrome. Changes in the duration of the QTC during anesthesia with propofol]. / La sindrome idiopatica del QT lungo. Variazioni della durata del QTC durante anestesia con propofol.

A prolonged electrocardiographic QTc interval may be unsafe during general anesthesia; thus successful anesthetic management in patients affected by congenital long QT syndrome include avoidance of any event that increases sympathetic activity and drugs that prolong QT interval. Propofol seems to have less effect on the QTc interval than tiopentone in normal subjects. This report suggest that propofol administration and infusion in clinical doses in a patient with Jerwell Lange-Nielsen syndrome may be safe and without increase of duration of QTc interval. The most marked changes in HR and QTc followed tracheal intubation and awakening suggesting a specific effect of cathecolamines.