[Effects of propofol in patients in status epilepticus of various origins. Electroencephalographic analysis]. / Effetti del propofol in pazienti in stato di male epilettico di varia origine. Analisi elettroencefalografica.

The authors discuss the effect of propofol administered to epileptic patients in intensive care. Several reports have attributed and antiepileptic effect to this drug, whereas a similar number have correlated it to epileptogenic manifestations of various types. Three "typical" cases of epilepsy were studied: chronic postoperative, chronic and acute post-traumatic. EEG patterns were analysed following continuous administration, using a bolus and using varying doses of the drug itself. Propofol appears to modify EEG patterns in a positive manner and is therefore confirmed as being useful in the sedation of epileptic patients in intensive care.

[General anesthesia for endobronchial laser therapy in a heart and lung transplant recipient]. / Anestesia generale per laserterapia endobronchiale in paziente trapiantato di cuore e polmoni.

The introduction of heart, lung and heart-and-lung transplants, only recently performed in Italy, has presented the anesthetist with the problem of the anesthesiological treatment of newly transplanted patients whose number will increase over time. For some time our unit has used general anesthesia using spontaneous breathing for endotracheal and endobronchial laser therapy. This solution was adopted in the case of a patient who had undergone a heart-lung transplant using an "a domino" technique some 90 days earlier. The authors discuss the results of the anesthesiological technique used taking into account the particular hemodynamic and respiratory characteristics of these patients.

[The use of propofol in status epilepticus]. / L'impiego del propofol nello stato di male epilettico.

Three cases of status epilepticus not responsive to an aggressive treatment are described. The seizures and EEG activity were rapidly brought under control with a continuous infusion of propofol (3-6 mg/kg/hour), maintained between 21 hours and 7 days. Patient awakening at the end of the infusion period was rapid and without sequelae.

[Use of propofol during laser therapy of the tracheobronchial tract]. / Impiego del Propofol durante laserterapia delle vie tracheobronchiali.

Anesthesia of the tracheobronchial (TB) pathways during laser therapy (LT) faces a variety of problems including analgesia and sedation in patients with respiratory difficulties or who continue to breathe spontaneously while the airways are occupied by operating instruments. During the course of the study, two methods of anesthesia were compared in 36 patients undergoing LT of the TB pathways. The first method (Group A, n = 16) involved the use of Diazepam as an hypnotic starter and Fentanyl as an opioid analgesic in continuous infusion. Propofol was used both as an inducer and as the main drug in the second method (Group B, n = 20) in order to reduce the opioid dose required. The following variables were studied: heart rate, systolic and diastolic blood pressure, blood gas analytic parameters, side-effects such as cough and intraoperative movement, and disturbances of heart rhythm and conduction; in addition, the duration of operations and the time taken to regain consciousness were recorded, together with the total dose of Fentanyl used. An improved hematosis was observed in patients treated with Propofol during the operation and on regaining consciousness, and the time taken to regain consciousness was significantly reduced. No significant differences were observed between the two groups with regard to cardiocirculatory variables or undesirable effects.

Testicular scan, diagnosis and followup for torsion of testis.

Testicular scan is an important method to improve the preoperative diagnosis of torsion of the testis. We used this method to diagnose torsion of the testis and for 3-month followup studies we correlated the followup scanning with testicular biopsy. We believe that one should always attempt to leave the twisted testicular portion in the scrotum because some vital cells might still be functioning.