Search

Awake fiberoptic intubation (AFOI) is mandatory to manage difficult airways. Superior laryngeal nerve block (SLNB) could reduce risks and improve patient comfort. The aim of this study is to assess the procedural comfort of SLNB during AFOI in a population of patients undergoing upper airway oncological surgery. Forty patients were randomized into two groups and were treated with continuous infusion of remifentanil, topic anesthesia and intercricoid block. In the study group (=20), SLNB was performed with lidocaine (L-SLNB); in the control group (n=20) SLNB was performed using saline (S-SLNB). AFOI was more comfortable in the L-SLNB group compared to S-SLNB patients [FOICS ≤ 1 in 18 patients (90%) L-SLNB; 2 (10%) S-SLNB (P0.001)]. Intubation was faster in L-SLNB (47.45 ±15.38 sec) than S-SLNB (80.15 ±37.91 sec) (p0.001). The SLNB procedure during AFOI is a safe and comfortable procedure in a population of patients undergoing upper airways surgery. Time to intubation was shorter in L-SLNB than in S-SLNB.

Childhood obstructive sleep disordered breathing (SDB) is a sleep-related upper airway obstruction that degrades sleep quality, ventilation and/or oxygenation; obstructive sleep apnea syndrome (OSAS) is one of the most common causes of SDB in children. The aim of this review is to evaluate the role of the anesthesiologist in pediatric OSAS.A literature review has been performed on the following topics: clinical aspects of pediatric OSAS, preoperative investigations including questionnaires, clinical parameters, laboratory polysomnography and home sleep apnea testing, anesthesiologic preoperative management, anesthesiologic perioperative management, anesthesiologic postoperative management including postoperative analgesia, postoperative nausea and vomiting (PONV), and post-tonsillectomy bleeding.OSAS in children is a distinct disorder from the condition that occurs in adults; adenoidectomy and tonsillectomy are the first line of therapy in these patients. Even if these surgical procedures are frequently performed, they represent a great challenge for surgeons and anesthesiologists and are associated with a substantially increased risk of morbidity and mortality.The role of the anesthesiologist is pediatric OSAS is crucial before, during and after surgery, as pediatric patients are at higher risk of preoperative, perioperative and postoperative adverse events including airway obstruction, PONV, and bleeding.

Questo Rapporto tecnico rappresenta la sintesi dei contributi (abstract) presentati al primo incontro del Gruppo di Lavoro Dinamica del Paleoclima del CNR che si è svolto a Bologna nella sede del CNR dal 17-18 Giugno 2019. Questo incontro ha avuto come focus la storia e la dinamica del clima durante gli ultimi 150 mila anni: dalla penultima glaciazione del MIS 6 attraverso l'ultimo interglaciale, le oscillazioni rapide che scandiscono l'ultima glaciazione, le culminazioni dell'Ultimo Massimo Glaciale e la transizione climatica al presente interglaciale. Di estrema rilevanza sono gli eventi che caratterizzano l'Olocene fino alla storia più recente degli ultimi 2000 anni, che forniscono la prospettiva a lungo termine degli studi sul cambiamento in atto. La sincronizzazione e teleconnessione degli effetti del cambiamento climatico negli ambienti marini e continentali; le oscillazioni del livello del mare e le stime di temperatura utilizzando la vasta gamma di proxies marini e continentali (dai sedimenti marini agli speleotemi, varve, carote di ghiaccio e piante) sono di speciale interesse a tutte le scale geografiche.

NON DISPONIBILE

Epiphyseal detachment-dislocation of the proximal femur constitutes a traumatic lesion, the immediate resolution of which always requires surgical treatment. How early treatment is carried out is important in improving the prognosis of the lesions which, however, in most cases is poor. In our case, clinical examination made 6 years post-surgery shows satisfactory preservation of range of movement with no important subjective disorders and with a minimal amount of hypometria (1 cm) even if structural epiphyseal changes visualized on radiographic examination and CT scan predict progression towards early arthritic degeneration.