[Quality of reawakening and dismissal after anesthesia with various techniques for minor surgical intervention. Clinical and medico-legal aspects]. / Qualità del risveglio e dimissibilità dopo anestesia con tecniche diverse per interventi di chirurgia minore. Aspetti clinici e medico-legali.

Different drug combinations were compared in order to assess the quality of anesthesiological control, tolerability and the speed of reawakening and recovery of self-sufficiency in 60 patients undergoing minor surgery. Propofol, combined with fentanyl and N2O due to its inadequate analgesic cover, showed a quickness of action with scarse side-effects, prompt reawakening and rapid recovery of deambulatory self-sufficiency in comparison to the associations of thiopentonefentanyl and thiopentone-isoflurane, thus indicating its preferential use in short surgical operations which can be carried out under a day hospital regimen. In addition, some medico-legal aspects of dimissional of recent developments regarding professional responsibility.

[Continuous positive airway pressure in the treatment of postoperative hypoxia]. / La CPAP nel trattamento dell'ipossia postoperatoria.

The physiopathology of postoperative hypoxia has been analysed, the cause being identified in the worsening of the V/Q ratio consequent on the reduction in CFR. By increasing CFR, CPAP reduces the superimposition of Tidal Volume and Closing Volume, thus reducing dysventilated zones and thereby improving the V/Q ratio and oxyaemia. With these premises, 18 patients undergoing cholecystectomy were examined; 8 of them were treated in the postoperative period with CPAP at pre-established intervals. The results confirm its effectiveness in terms of PaO2 improvement and the need for constant administration, considering that the benefits are lost when the patient is disconnected from the mask.

[Pancoast's syndrome from the analgesic viewpoint. Our current orientation]. / La sindrome di Pancoast Tobias dal punto di vista antalgico. Nostro attuale orientamento.

Based on the neuroanatomic and physiologic characteristics, the pain from the Pancoast's syndrome is distinguished in cervical-brachial and thoracic-scapular. Two new surgical methods are described for the antalgic treatment of this syndrome: release of the brachial plexus, dissection of the over-scapular nerve and removal of the stellate ganglion, in the first case; dissection of the first two (or three) intercostal nerves and subsequent removal together with their thoracic ganglions, in the second case. The advantages of the above methods and the results reached are discussed.