[Peridural anesthesia and narcosis with propofol in thoracic surgery]. / Anestesia peridurale e narcosi con propofol in chirurgia toracica.

Twelve patients undergoing elective thoracic surgery because of lung cancer, have been studied. The anesthetic management included: continuous epidural anesthesia with bupivacaine (T6-T7), continuous infusion of propofol and vecuronium, mechanical ventilation with an oxygen/air mixture. We evaluated the perioperative analgesia and the cardiovascular side effects of two groups of patients differing for the position (supine or lateral) selected to administer the local anesthetic. We also analysed the most important characteristics of the recovery from anesthesia (degree of analgesia and consciousness, respiratory function and cooperation with physiotherapeutic manoeuvres). The authors conclude that, although the number of patients studied is limited, there are no significant differences between the two groups for intraoperative analgesia and hemodynamic imbalance; the anesthetic technique employed is a reliable alternative to classic balanced anesthesia, because seems to reply very well to the mayor purposes of thoracic surgery. Moreover it makes the operative room free from pollution caused by volatile anesthetics.

[Antibioticotherapy based on statistics in intensive therapy]. / Antibioticoterapia su base statistica in terapia intensiva.

The authors present the epidemiological data concerning nosocomial infections in their Intensive Care Unit, and discuss an antibiotic strategy statistically oriented by these data. In their experience, treatment based on statistical criteria, brought to a reduction in antibiotic consumption with particular regard to broad-spectrum antibiotics, and to a decrease in individual budget.