[Intravenous versus inhalation anesthetics in anesthesia for bone marrow harvest for transplantation]. / Anestetici endovenosi versus inalatori nell'anestesia per il prelievo di midollo osseo a scopo di trapianto.

It is well known that nitrous oxide and many volatile anaesthetic drugs possess a certain degree of myelodepressive activity. The authors' aim has been to evaluate the degree of proliferative activity after exposure to forane or propofol. Bone marrow samples have been cultured after general anaesthesia induced and maintained by the same agents; cultures have also been performed after samples exposure to forane and propofol. The results have not shown significative differences in the haemopoietic colonies growth of bone marrow harvested from patients underwent intravenous or inhalatory anaesthesia. In vitro study has shown a significative variation of the colonies growth at the forane higher concentration. Intravenous anaesthetic may be safer for bone marrow harvest for transplantation.

[Anesthesiologic management for lower pulmonary lobectomy intervention in patients with heart transplant. A clinical case]. / Condotta anestesiologica per intervento di lobectomia polmonare inferiore in paziente cardiotrapiantato. Caso clinico.

The Authors describe the case of a patient who had undergone human allograft cardiac transplant seven months before inferior pulmonary lobectomy for neoplasia. The pulmonary neoplasia had been revealed by X-rays during the periodic check-up examinations. Because of the high risk of infection following corticosteroid and immunosuppressive therapy, sterile equipment for invasive monitoring and oro-tracheal intubation has been used. The denervated heart presents peculiar haemodynamic and pharmacological aspects that the anaesthetist must pay attention to in the conduction of a general anaesthesia; moreover, arrhythmias are common in the recently transplanted heart. Anaesthesia has been induced and maintained by an association propofol-fentanyl that showed a good cardiocirculatory stability; neither arrhythmias have happened, nor the need for drugs different from those of anaesthesia and resuscitation have occurred.