[Loco-regional anesthesia vs general anesthesia in carotid endarterectomy. Response to the surgical stress]. / Anestesia loco-regionale vs anestesia generale nell'endoarterectomia della carotide. Risposta allo stress chirurgico.

The advantages of performing carotid endarterectomy in the awake patient, perioperative analgesia, circulatory parameters, plasma cortisol and PRL response to surgery have been evaluated. Ten patients were submitted to general anaesthesia and ten patients to superficial and deep cervical block. The Authors conclude that, although the number of patients studied is limited, there are no significant differences between the two groups for intraoperative analgesia, hemodynamic imbalance and plasma cortisol and PRL. This result support the belief that carotid endarterectomy in awake patients can be safely performed on patients with chronic obstructive pulmonary disease.

[Prevention of myalgias caused by succinylcholine with a small dose of a non-depolarizing muscle relaxant]. / La prevenzione delle mialgie da succinilcolina con una piccola dosse di miorilassante non depolarizzante.

Precurarisation with 1 mg/15 kg d-tubocurarine was given before 1.5 mg/kg succinylcholine to obtain muscle relaxation for tracheal intubation in 100 patients, whereas 1 mg/kg succinylcholine only was administered to 100 controls. Serious postoperative myalgia fell from 8% to 0%, and forms of average intensity from 21% to 8% in the curarised group. Muscle resolution was regarded as satisfactory in 96% (98% in the controls). The effectiveness and degree of safety of this combination are discussed, together with the indications and contraindications for the employment of the technique in the prevention of myalgia induced by succinylcholine.

[Chemical rhizotomy using phenol in the treatment of perineal pain of neoplastic origin]. / Rizotomia chimica con fenolo nel trattamento delle algie perineali di origine neoplastica.

The Authors report the results obtained in 53 patients treated with intrathecal injections of 5% phenol in glycerin for the control of serve pain caused by rectal and genital cancer. The method used for determining the sensory roots to be blocked and the technique of drug administration are described. The effects of subarachnoid phenol blockade have been evaluated on the basis of pain relief (measured by the visual analogue test) and improved general well being. The observed results indicate that this is one of the most effective and safest procedures in the management of perineal cancer cancer pain.