Vito Aldo Peduto

University of Perugia | UNIPG · Scienze chirurgiche e biomediche

BACKGROUND AND AIMS: We analysed renal, pulmonary, cardiac and hepatic comorbidities in the adult population of Italian ICUs. Our aim was to establish which comorbidity would most affect the outcome of patients admitted to Italian ICUs. The secondary aim was to investigate the role of aging on outcome. SUBJECT AND METHODS: In this cross-sectional s...

Background: The management of a septic peritonitis open abdomen is a serious problem for clinicians. Open surgery is associated with several complications such as bleeding and perforation of the bowel. Case presentation: The authors report a case of a 59-years-old female who underwent a sigmoid resection with an latero-terminal (L-T) anastomosis...

We report the case of an 84-year-old man admitted to ICU with symptoms/signs occurring after upper respiratory airways disease. The upper respiratory condition consisting in an uvula oedema required an empiric antiinflammatory and antibiotic therapy which masked the clinical features usually seen in the case of rickettsial infections, especially cu...

Background There are still no clear guidelines in the literature on per procedural bronchoscopic management for anesthesiologists, and few relevant datasets are available. To obtain rapid recovery from anesthesia, it is often necessary to keep patients in the recovery room for several hours until they become clinically stable. In this study, we tes...

Background: Cricopharyngeal foreign bodies (FBs) impaction in adults is a common clinical problem; without treatment, the sequelae may be lethal due to local and/or mediastinal infection. When direct laryngoscopy and flexible fiberoptic endoscopy are ineffective, rigid endoscopy is the method of choice requiring general anesthesia. The new video l...

Anesthesiology, which includes anaesthesia, perioperative care, intensive care medicine, emergency medicine and pain therapy, is acknowledged as the leading medical specialty in addressing issues of patient safety, but there is still a long way to go. Several factors pose hazards in Anesthesiology, like increasingly older and sicker patients, more...

Background. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is unclear. Methods. 46 women with ASA physical status 1 undergoing cesarean section were randomly allocated to 2 groups. Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in th...

Efficacy of epidural local anesthetics plus steroids for the treatment of cervicobrachial pain is uncertain. A prospective study randomized 160 patients with cervicobrachial pain resistant to conventional therapy. Patients were divided into 4 groups on the basis of the time between pain onset and treatment initiation: group A, 40 patients with pain...

Dreaming during anesthesia is not a well-understood phenomenon. Anticholinergic drugs are used in anesthesia as premedication, but their use to decrease the incidence of dreams and psychological adverse reactions after anesthesia is not well established. The authors therefore studied the efficacy of intramuscular atropine and scopolamine for the pr...

Among the anesthetic technologies used, regional anesthesia is becoming the most common in cesarean section (CS) deliveries. Aim. This retrospective survey examined the variables taken into account when selecting the anesthetic technique to be used, and how this choice affects the outcome for the mother and the newborn. One thousand eight hundred a...

Clonidine is effective in treating sevoflurane-induced postanesthesia agitation in children. We conducted a study on 169 children to quantify the risk reduction of clonidine agitation in patients admitted to our day-surgery pediatric clinic. Children were randomly allocated to receive clonidine 2 mug/kg or placebo before general anesthesia with sev...

The incidence and duration of apnea during sevoflurane anesthesia have not been fully characterized. We hypothesized that sevoflurane at slowly increasing concentrations reduces incidence and shortens the duration of apnea compared to administration of a highly concentrated anesthetic mixture. 131 women were randomly assigned to receive 35% oxygen...

To achieve more information on anaesthesia practice in Italy. One questionnaire was completed for every anaesthetic procedure performed during the last week of June 1999 in 162 public hospitals selected in the northern, central and southern parts of Italy. A total of 12 263 anaesthetic procedures were performed during the study week in participatin...

This prospective, randomized, observer-blinded study compared onset time and duration of epidural anaesthesia produced by with levobupivacaine and ropivacaine for lower limb surgery. ASA I-III adult patients undergoing elective lower limb procedures were randomized to receive epidural levobupivacaine 0.5% 15 mL (n = 30) or epidural ropivacaine 0.75...

Continuous and intermittent administration of inhalational anesthetics has been successfully employed for treating pain during labor. We conjectured that intermittent sevoflurane administration would be effective for pain relief during labor without side effects to the mother or fetus. Fifty parturients breathed a mixture of 2-3% sevoflurane, oxyge...

Pedanius Dioscorides of Anazarba in Cilicia lived in the first century. He was a Greek physician who served as a surgeon in Neròs army. He wrote several books on materia medica. One of his manuscripts with drawings of medicinal herbs was copied down in the fifth century. In this book on Greek Herbal, still kept in the National Library of Vienna, Di...

To compare ease of maintenance and recovery characteristics of sevoflurane and propofol plus fentanyl in day-care anaesthesia, 60 outpatients undergoing elective surgery of up to 3 h duration were randomized to receive sevoflurane or propofol as their primary anaesthetic. Induction was always carried out with propofol, but a fentanyl bolus 5 microg...

Rather than a summary of the contribution of molecular pharmacology, perhaps the main conclusion from this review is that a more pharmacological approach would aid our understanding of the mechanism of general anesthesia. Analysis of the actions of anesthetic agents needs to take into account the well-established pharmacological principle that almo...

Diprifusor TCI is a newly developed target-controlled system for the infusion of propofol. Purpose of this study is to evaluate the acceptability, efficacy and safety of Diprifusor TCI in comparison with the manually controlled technique. This multicentre, randomised, parallel group study was carried out in 160 patients undergoing surgical procedur...

We present a case of accidental epidural administration of potassium chloride, which was diagnosed by clinical signs. The genesis of symptoms and signs following such administration is discussed and compared with other published reports.

The goal of this multicenter, prospective, randomized clinical investigation was to compare the clinical efficacy and safety of sevoflurane and isoflurane during the maintenance of and the recovery from general anaesthesia in elderly patients. With the approval of the Ethical Committee and the patient informed consent, 104 ASA physical status II-II...

Combined analgesic regimens have been suggested to improve the treatment of postoperative pain. The aim of our study was to evaluate the analgesic efficacy and tolerability of propacetamol, in combination with morphine. Four i.v. infusions of propacetamol 2 g or placebo were administered, in a double-blind fashion, after orthopedic surgery (n = 97)...

After an in-depth analysis of the field characteristics and possible users, old and new anaethesiologic drugs, most suitable for clinical use, both self-administered and combine with one another, are mentioned, dwelling upon the type of sedation most indicated in endoscopy. As proof of this field great interest, 367 references enrich the study.

Considering that patients admitted to a hospital are frequently given regular drug therapy (the incidence being 24%-42% overall and increasing to 70% in patients aged over 70 years) (1, 2), that each patient may receive on average 9.4 drugs during hospitalization (3), and, finally, that another ten or more drugs may be given for a “routine” anesthe...

Since NSAIDs are competitive antagonists of cyclooxygenase, they prevent the biosynthesis of prostaglandins, responsible for enhanced nociceptive sensitization and primary hyperalgesia. If NSAIDs administration is performed after eicosanoids cascade activation by surgical trauma, already released prostaglandins can exert their hyperalgesic effects...

The term SIDS describes the unexpected and unexplained death of an apparently well infant. After congenital anomalies, SIDS is the most common cause of infant death in the industrial countries and it is the leading cause of death among infants older than 1 month. Descriptive epidemiological studies have shown a winter excess of cases and a peak of...

Pulse oximetry is dependent upon the presence of a pulsating vascular bed. The signal detection will be impaired in the presence of vasoconstriction or venous congestion, conditions which may occur readily in clinical practice. We compared the oximetric measurements (SpO2) at the hand and the foot with arterial hemoglobin saturation (SaO2) during l...

Immediately following delivery a newborn infant was severely depressed. Because no respiratory effort was made and copious mucus was present, a Cole endotracheal tube was easily inserted into the trachea. Because of a mistaken manoeuvre for fastening the tube, the plastic adapter connection became dislodged from the tube, and the tube slipped out o...

Carbamate and organophosphate poisoning is a well known toxicological problem in developing countries, but still has, even in industrialized ones, a high mortality rate and a frequent invalidating outcome. Serious problems especially arise from cardiac (toxic myocarditis, QT prolongation, and other ventricular arrhythmias), muscular (intermediate s...

We report the recollections of an anaesthesiologist who experienced urogenital surgery under balanced anaesthesia which was insufficient to prevent awareness during a part of the procedure. The patient was hard apprehensive before surgery and neither sedative nor amnesic drugs were done as premedication. He received an Innovar, thiopentone, suxamet...

A case of severe tetanus with autonomic dysfunction is reported, describing the adequate response to continuous infusions of both propofol and midazolam, and the successful use of clonidine to control sympathetic over-activity. Tolerance was not observed during the 34 days of propofol and midazolam sedation. Continuously infused clonidine provided...

Atrial natriuretic factor (ANF) is a peptide hormone released from atrial cardiocytes in response to atrial stretch. It has potent and selective effects on vascular smooth muscle, fluid and electrolyte balance, and may interact with other vasoactive substances. The influence of anaesthesia and major vascular surgery on the release and circulation o...

Owing to a car accident, the clothes of a injured joiner were permeated with a timber impregnating product containing 51.8% of mineral spirit (a mixture of naphthenes, aromatic and aliphatic hydrocarbons). Despite a short-lasting skin exposure (approximately 40 minutes), dermal contact has caused full thickness burns that, in their turn, have made...

The influence of propofol, a new intravenous anesthetic agent, on brain gamma-aminobutyric acid (GABA)-ergic transmission has been investigated both in vitro and in vivo. In vitro, propofol, like benzodiazepines, 1) markedly enhanced 3H-GABA binding in cortical membrane preparations; 2) potentiated muscimol-induced stimulation of 36Cl- uptake in me...

The possible molecular mechanisms potentially inducing occupational disease among operating room personnel were examined; and the really dangerous anaesthetic agents were identified. As concerns the molecular mechanisms of parenchymatous injury, we surveyed: those connected with free radicals and biological reactive intermediates produced during ha...

Skin necrosis has not been described as a complication following epidural sympathetic blockade. We report a case of bilateral extensive skin necrosis of the lower limbs after a 48-hour lumbar epidural blockade in a 71-year-old patient with right hemiplegia and mitral valve regurgitation, without any preoperative clinical evidence of peripheral vasc...

In three operating rooms of a Sardinian hospital, the Authors have measured the air levels of isoflurane using static samplers. Anaesthetic mean daily concentrations ranged from 3.5 to 41.5 ppm in room A, from 4.1 to 24.4 ppm in room B, from 9.5 to 30.4 ppm in room C above all depending on the length and the number of surgical operations. The Autho...

Rats which had approximately 25-30% of their calculated blood volume removed were exposed to halothane (1%) or enflurane (2%) in 33% oxygen for 30 min. Hepatic function was evaluated by determining, at various time intervals, serum activities of glutamic-oxalacetic and glutamic-pyruvic transaminase, acid phosphatase and gamma-glutamyl-transpeptidas...

The purpose of this study was to evaluate the effect of isofluorane anesthesia on the hemodynamics of patients undergoing reconstructive vascular surgery (abdominal aortic aneurismectomy) and to compare the results with those obtained with halothane or enflurane anesthesia in similar groups of patients.

PIP: 60 outpatients who submitted to termination of pregnancy at less than 12 weeks gestation (legal abortion) were randomly anesthetized with fentanyl + thiopentone, ketamine + diazepam, thiopentone + halotane, or thiopentone + enflurane. Each patient breathed spontaneously 3 liters/minute of nitrous oxide. The psychomotor recovery time was evalua...

Wistar male rats were subchronically (150 h continuously) or chronically (5 h daily for 15 days) exposed to a 50% nitrous oxide/oxygen mixture. As an index of enzyme induction liver N-demethylase and benzo(a)pyrene-hydroxylase activities, serum gamma-glutamyltranspeptidase activity, urinary d-glucaric acid and pentobarbital sleeping time were evalu...

The analgesic activities of a 75:25% nitrous oxide-oxygen mixture administered for 15 min, of Δ-9-tetrahydrocannabinol (THC) 10 mg kg−1 i.p., and of a combination of both, were evaluated in the rat by tail-flick and hot-plate tests. The nitrous oxide-oxygen mixture produced a significant increase in the pain threshold. The analgesic activity of THC...

Female rats have been exposed (24 hours for 15 days) to N2O 60% in normo-oxic blend of N2 and O2. Vaginal smears have been observed daily. At the end of the experiment the ovaries have been removed and the following morphological parameters have been statistically evaluated: number of evolutive follicles and corpora lutea, amount of interstitial ti...

In this fourth chapter of the review on the so-called halothane hepatitis, the experimental trials and the attempts to reproduce experimentally the syndrome, with particular care to recently identified 'hypoxic model', have been critically examined. Available data give an interlocutory judgement on the existence and distinctive features of 'halotha...

In relation to the ever increasing diffusion of drug addiction, to the hypothetical interferences of the drugs of abuse with those of anaesthesia, and to the peculiar difficulties facing the anaesthetist with an addicted patient, we thought of topical interest to examine, from the anaesthesiologist's viewpoint, the questionable aspects of this soci...

Experiments were performed on rats using two analgesimetric tests (tail-flick; hot-plate) before and after injection i.v. of graded doses of apruunin (12.5, 25.0 and 50 KIU g−1). A dose-related analgesic effect was noted with both tests. Prior administration of naloxone 0.001 mg g−1 i.p. inhibited the analgesic action.

Unforeseen congenital methaemoglobinaemia caused severe cyanosis during anaesthesia. The clinical implications and eventual interaction with other drugs are discussed.

Rats were caged during 8 hours/day, 5 days/week and during 8 weeks in air contaminated with enflurane. Blood levels of enflurane were measured at the beginning and at the end of each week of exposure and after various time intervals after the final exposure. Data obtained revealed a progressive accumulation of enflurane in the blood where it is pre...

The hypothetical analgesic effects of intravenous infusion of ketoprofene in doses of 300 and 600 mg, respectively, were assessed and compared statistically to those of a placebo solution in 45 patients submitted to cholecystectomy. This assessment was based on subjective and objective features and the variations in threshold to an applied electric...

Testicular effects of nitrous oxide have been studied in rats breathing 12 hours daily, during 7 weeks, a mixture of air and oxygen with 20% nitrous oxide. Microscopically there was observed a progressive depression and disorganization of germinal cells, with a maximum in the 5th week of treatment, followed by a certain degree of recovery. The Leyd...

Changes in leukopoiesis and splenic morphology were studied in rats exposed to 20% nitrous oxide in oxygen for 10 days. Statistically significant granulocytopenia and lymphocytopenia were noted. Red cell formation, lymphopoiesis and macrophage activity of the spleen were found to be increased. By control experiments, all other provoking factors wer...

The effects of varying degrees of histamine depletion on the contractile response to noradrenalin of an aortic strip of rat were assessed. Histamine was measured directly on the specimen. The contractile response to noradrenalin diminishes in proportion to the diminishing histamine concentration. The possible effects of these resulting data on the...

Isolated rat aorta was immersed in a solution of hydrocortisone phosphate or hemisuccinate (100 to 400 mg/l) to search for changes in its reactivity to noradrenaline. Aorta was also stimulated with potassium chloride to eliminate any possible direct action of hydrocortisone on the vascular muscle cells. Results showed that lower doses of hydrocorti...