F Bressan

University of Florence, Florens, Tuscany, Italy

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Publications (7)15.49 Total impact

  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2010; 27.
  • F Bressan, G Buti, S Boncinelli
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    ABSTRACT: Simulators are more and more widely used in different scientific areas. Through very sophisticated and realistic simulations, they actually permit to teach and demonstrate theoretical or practical notions. Besides, they allow to evaluate a particular performance. In the latest years, the use of simulators has considerably developed in medicine. Anaesthetists have been the first to use and develop simulation. Having the possibility to deal with emergencies and getting accustomed to them without any real risk is an undeniable advantage. Even though the long-term effects due to a simulation session haven't been properly evaluated yet, it is important to bear in mind that simulators are being successfully used in an impressive number of centres in different parts of the world. The activities in the medical simulation centres deal to a certain extent with studying and teaching to manage critical events. This particular discipline, deriving from the aeronautic field, relies upon decision making and teamwork in order to manage the critical event most appropriately. Formative trainings, initially meant for anaesthetists and later on open to other medical categories as well, have been developed. Such courses aimed at establishing the proper interactions between different people with different tasks who are involved in the approach to an emergency rather than the management of the whole scenario. The main drawback of simulation is, however, the high costs required to set a simulation programme, especially as far as the human resources involved are concerned.
    Minerva anestesiologica 01/2007; 73(1-2):1-11. · 2.82 Impact Factor
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    ABSTRACT: Measurement of skin temperature can be used as an indicator of sympathetic blockade induced by neuraxial anaesthesia. The aim of the study was to test the skin temperature response to epidural administration of bupivacaine and different concentrations of ropivacaine. Forty-eight ASA class I-II patients undergoing herniorraphy were enrolled into a prospective, randomized, double-blind clinical trial. Patients were randomly allocated to receive epidural anaesthesia with a single dose of 18 ml of bupivacaine 0.5% (n=16); ropivacaine 0.5% (n=16), or ropivacaine 0.75% (n=16). A temperature probe was positioned on the skin of the thigh and skin temperature registered before epidural anaesthesia, every 10 minutes for the first hour after the epidural injection and every hour for the following four hours. Sensory blockade was assessed by pinprick and motor blockade using the Bromage scale. No significant difference was observed in sensory or motor blockade. A skin temperature rise of 1 to 1.8 degrees C compared with basal values was observed in all patients within the first hour. Temperature returned to basal values within four hours in the ropivacaine 0.5% group, within five hours in the ropivacaine 0.75% group, and remained 1 degrees C higher after five hours in the bupivacaine 0.5% group (P<0.01). The duration of sympathetic block is significantly shorter with ropivacaine than with bupivacaine.
    Anaesthesia and intensive care 07/2006; 34(3):334-7. · 1.40 Impact Factor
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    ABSTRACT: This study examines the quality of patients' informed consent in patients undergoing minor surgical procedure. Information provided on risks and complications inherent in anaesthesia-care and patients' awareness of specific risks involved in anaesthesia were recorded, and the influence of a questionnaire-form was evaluated. This is a prospective controlled study. In the first part (Group I: n=71) social and demographic data, complications and risks communicated to the patient in the preanaesthetic evaluation, as well as patients' satisfaction with the information obtained, were noted. In the second part of the study (Group II: n=201) patients were also asked to answer a questionnaire form concerning their own state of health and their knowledge of risks in anaesthesia. The statistical analysis was conducted using Pearson's Chi square test or t test, and by fitting suitable logistic models. The frequency of the communication of at least one of the risks and complications of anaesthesia has been 43.7% in GI and 59,7% in GII, p=0.019. Patients in class ASA III were informed more (77%, c.i. 59-90) as compared to those in class ASA I-II (52%, c.i. 45-59) (p=0.008); 37% in class ASA I-II and 65% in class ASA III desire the presence of one of their relatives during the preassessment (p=0.016). Our results indicate that most patients are glad to be informed, even if they are unaware of the risks and complications of anaesthesia. The questionnaire form seems to be an important tool for patient education. Ethical questions are proposed.
    Minerva anestesiologica 12/2002; 68(11):811-8, 818-23. · 2.82 Impact Factor
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    ABSTRACT: To survey current anaesthesiology practice in Italy. We submitted to 1260 Italian anaesthesiologists in 12 different regional places a structured form aimed at surveying their common work practice. Our sample consisted of anaesthesiologists, age 26-63, with 1-35 years of professional practice. We believe that our sample represents about 7-10% of Italian anaesthesiologists, reflecting a global number of 600,000 procedures performed during 2000. The results have been analyzed by an Excel spreadsheet and they are reported as mean of the percentage of use declared in the case of drugs, and as percentage of the responses in the case of procedure and monitoring systems used. Furthermore we divided our sample population according to two criteria: principal place of work (general operating rooms (OR), subspecialty ORs, ICU) and years of anaesthesiology practice (<5>). The results have been crossmatched within and between the subgroups. The survey showed a composite state of anaesthesia practice in Italy. The main differences are between the youngest and the oldest anaesthesiologists and between the anaesthesiologists working mainly in the ICU and in the ORs. Italian anaesthesia practice is still a very composite reality.
    Minerva anestesiologica 11/2002; 68(10):751-63. · 2.82 Impact Factor
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    ABSTRACT: Deep vein thrombosis and subsequently pulmonary embolism are the most common causes of increased post-operative morbidity and mortality in patients with pelvic or abdominal cancer. Aim of the study was to evaluate variations in coagulative parameters induced by two accepted primary prophylaxis patterns: standardized low doses of unfractioned heparin (UFH) or single doses of low molecular weight heparin (LMWH) in cancer patients submitted to radical retropubic prostatectomy. Fifty patients (45-75 yr) were randomly assigned two groups. Group 1 received UFH (5000 units s.c. x 3 daily); group 2 received calcium nadroparin (single daily dose of 0.3 ml s.c.). In both groups prophylaxis began preoperatively and was maintained throughout the entire hospital-stay. Blood cell, platelet count, coagulative system exploring tests, thrombotic molecular markers, and physiological inhibitors of coagulation were determined at baseline conditions and on the first and seventh day after surgery. Preoperative values of fibrinogen, F1+2 fragment, TAT and D-dimer resulted over normal range in both groups. A significant increase of these markers was observed also during the post-operative period. PT, aPTT, ATIII, PC, total and free PS showed the most substantial changes on the 1st post operative day, though their values ranged within normal levels on the three sampling times. The levels of haemostatic markers demonstrated a baseline hypercoagulability, probably related to cancer and thrombin activation caused by prostatectomy. Despite this thrombophylic state, neither of the two groups presented symptomatic bleeding or thromboembolic complications. These results prove that a single daily dose of nadroparin has been safe and efficient as a thrice-daily dose of UFH, with a better risk/benefit relationship.
    Minerva anestesiologica 11/2001; 67(10):693-703. · 2.82 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the discharge rate of children undergoing ophthalmic surgery of medium length (69-120') in a day-hospital regime under general anesthesia with orotracheal intubation and using Sevoflurane as the only anesthetic agent. Experimental protocol: prospective study. Setting: the study was carried out in the operating theatre of the Ophthalmic Clinic at Florence University. Patients: 58 pediatric patients aged 2-10 years, ASA I-II, 13-34 kg. Operations: correction of strabismus, cataract, glaucoma, palpebral ptosis and intubation of lacrimal tracts. Parameters measure: Any signs of reactivity in the airways to Sevoflurane on induction or reawakening (cough, bronchospasm, laryngospasm and psychomotor agitation), hemodynamic variables (heart rate and NIBP); reawakening time (from turning off the vaporiser to extubation), discharge time from recovery room (SatO2 > or = 97% in ambient atmosphere), discharge time from hospital (stable vital signs, response to simple and complex commands). The mean reawakening time was 7 min, discharge time from the recovery room was 20 min, discharge time from the hospital 80% after four hours, 100% after six hours. No respiratory and/or cardiovascular complications were reported nor psychomotor agitation. General anesthesia with Sevoflurane and Atracurium was found to be a realistic and reliable technique in pediatric ophthalmic surgery of medium length performed in day hospital.
    Minerva anestesiologica 12/2000; 66(11):807-10. · 2.82 Impact Factor