Biochemical changes in neurosurgical patients under critical care treated with mannitol.

A Study was carried out on ten patients undergoing operations for brain tumors, who were treated with mannitol solutions. This caused a significant depletion of serum sodium ion and in an increase of discriminate osmolality (to 60 mosM/kg H2O). A hypothesis about the particular biochemical mechanism, involving the electrolyte and water distribution, is presented.

Early changes in cerebrospinal fluid Ca2+ and FFA levels following experimental spinal cord injury.

Cerebrospinal fluid (CSF) Ca2+ and free fatty acids (FFA) levels were determined for 4 h following experimental spinal cord (SC) injury in rabbits. The injury was produced by dropping a 20 g weight from 20 cm on exposed dura mater at the C5-C6 level. Samples of CSF were obtained from the cisterna magna from a second laminectomy at the C1 level. A significant decrease in CSF Ca2+ levels was observed 10 and 30 min post-injury; such levels increased above normal values 180 min post-injury. A significant increase in CSF FFA levels was seen from 10 to 240 min post-injury with a peak at 30 min. The early decrease of CSF Ca2+ levels and the concomitant increase in CSF FFA levels seem to confirm in role of Ca2+ in mediating the lipolytic response of the SC tissue to trauma.

[Anesthesia in the early surgical therapy of myelomeningocele]. / L'anestesia nella terapia chirurgica precoce del mielomeningocele.

Anaesthetic procedures in surgical repair of meningomyelocele in pediatric patients with particular reference to the problems concerning the specific pathology and the newborn age are reported. Authors consider that surgical repair in the first days of life assures a lesser incidence of leptomeningeal infections and a better functional improvement without an important increase of the anaesthetic risk.

[Use of fazadinium in heart surgery. Clinical contribution]. / L'uso del fazadinio in cardiochirurgia. Contributo clinico.

A new muscle relaxant, fazadinio bromide, has been administered to 10 heart patients awaiting surgery and its induction utility assessed. A constant though non-significant increase in heart frequency, a significant reduction in maximum and a non-significant reduction in minimum arterial pressure were recorded. No arrythmia or changes in effort-induced cardiac index were seen. The short latency period and myoresolution characteristics permitted speedy, atraumatic intubation. While these features and the absence of arrhythmia suggest the drug might have some clinical utility, tachycardia and arterial hypotension limit its use in heart patients.

[Risk and choice of anesthetics for patients with previous malignant hyperthermia syndrome]. / Rischio e scelta anestesiologica in pazienti con pregressa sindrome di ipertermia maligna.

Two cases of m.h. are reported. Various parameters--age of patients, predisposing situation and diseases, family history and enzyme changes, use of certain anaesthetics and myorelaxant--are examined and evaluated. Alternative anaesthesia techniques are suggested for patients presenting a family history of m.h. or who have manifested the syndrome on other occasions and who have to undergo further surgery.