[Temperature monitoring and sites of measurement of body temperature]. / Monitoraggio termometrico e siti di rilevamento della temperatura corporea.

The authors report an investigation of 331 consecutive patients submitted to major surgery to evaluate the reliability of temperature monitoring in different body sites in relation to central temperature. After having considered the minimal temperature changes and the difficulties due to the different techniques used, it is concluded that the measurement at the middle 3rd of the oesophagus is the most reasonable measurements site.

[The propofol-fentanyl-pancuronium combination in aorto-coronary bypass. Experience and personal caseload]. / L'associazione propofol-fentanyl-pancuronio nei by-pass aorto-coronarici. Esperienza e casistica personali.

The authors report the use of a total intravenous anaesthesia in CABG. An association of propofol-fentanyl-pancuronium with a bolus at induction, then with continuous perfusion was used. Hemodynamic and oxymetric data obtained from the right heart and radial artery samples show good hemodynamic stability during surgery. It is underlined that, in order to reduce possible hemodynamic changes it is very important to use, during the surgical procedure, the lowest drug concentration.

[Circulation effects of noradrenaline in hyperdynamic septic shock]. / Effetti circolatori della noradrenalina nello shock settico iperdinamico.

The authors report on a group of 8 patients in septic shock, treated with NA in association with dopamine and/or dobutamine, according to a personal therapeutic protocol. The use of NA in septic shock with low SVR showed an improvement in hemodynamic condition and a higher survival rate in the treated patients. During the study many clinical, laboratory and microbiologic data were also recorded.

Regional cerebral blood flow after omental transposition to the ischaemic brain in man. A five year follow-up study.

Regional cerebral blood flow, recorded by the 133Xenon inhalation method, was measured preoperatively and over a five years postoperative period in six patients with completed stroke and stabilized neurological deficits, who had undergone omental transposition for revascularization of the ischaemic brain. Comparisons of the preoperative blood flow values with those recorded following surgery demonstrate a postoperative increase of blood flow in five patients, with a high statistical degree of significance in four of them at the final examination. The flow increase was noted over the infarcted areas of the brain, upon which the omentum had been placed, as well as areas of the ischaemic hemisphere without omental placement and the contralateral hemisphere. Out of the five patients who demonstrated preoperative flow values below the expected norm for age, four showed final postoperative cerebral blood flow within the normal limits for their age. The results are consistent with the assumption that the transposed omentum played a role in postoperative blood flow increase, by adding collateral circulation to the ischaemic brain.

Omental transposition or transplantation to the brain and superficial temporal artery--middle cerebral artery anastomosis in preventing experimental cerebral ischaemia.

Transposition of lengthened omentum to the brain surface, transplantation of an omental graft, or superficial temporal artery--middle cerebral artery anastomosis were performed in dogs prior to transcranial occlusion of the ipsilateral middle cerebral artery at its origin, including the bifurcation of the internal carotid artery. Both omentum and by-pass were able to reduce the changes in cerebral blood flow, somatosensory evoked responses, cerebral water and electrolyte content, consequent to the ischaemic insult. In the experimental conditions adopted in this study, the effect of omental transposition in maintaining high levels of flow throughout the entire occluded hemisphere was more marked compared to that resulting from the other methods, while the onset of ischaemic cerebral oedema was affected approximately at the same degree by all procedures. The results point to the role of the transposed omentum in providing an effective collateral circulation to the ischaemic brain.

Anticonvulsant activity of Althesin on experimental epilepsy.

Anaesthetic doses of Althesin were tested in rabbits using two experimental models of epilepsy: generalized (OHP; oxygen at high pressure-induced seizure) and partial (penicillin cortical-induced seizure). Althesin in both models always produced anticonvulsant activity which was more powerful in generalized convulsions. This agent was successful in preventing and treating OHP seizures. The authors conclude that a clinical history of convulsions must not be considered a contraindication to the use of this anaesthetic which has particularly useful properties for neurosurgery.