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Research paper thumbnail of Impact of metabolic syndrome in surgical patients: should we bother?: Table 1

British Journal of Anaesthesia, 2015

ABSTRACT

Research paper thumbnail of Anaesthesia and the QT interval. Effects of isoflurane and halothane in unpremedicated children

Research paper thumbnail of Somatostatin and total intravenous anaesthesia. Assessment of analgesic requirements during surgery and the effects on liver enzymes

Anaesthesia

We have studied the analgesic effects of somatostatin during surgery and its influence on the pla... more We have studied the analgesic effects of somatostatin during surgery and its influence on the plasma glucose levels and the liver enzyme profile in 40 ASA 1 or 2 patients undergoing surgery for carcinoma of the gastrointestinal tract. Each patient received either somatostatin bolus 3.5 micrograms.kg-1 intravenously plus an infusion of somatostatin 3.5 micrograms.kg-1.h-1, or sodium chloride 0.9% as a placebo in a double-blind manner. Anaesthesia was induced with propofol 1 mg.kg-1 followed by a continuous infusion of propofol in a stepwise declining regimen. Vecuronium was used for muscular relaxation. Fentanyl 100 micrograms was administered intravenously in bolus doses for analgesia during surgery as required. Blood samples were taken at 10 min pre-induction, 5 min postintubation, 5, 30, 60, 120 min postincision and 30 min post-recovery for plasma glucose levels. Blood samples were also taken at 10 min pre-induction, 120 min postincision and 24 h postoperatively for liver enzymes. The total requirement for fentanyl in the control group was significantly higher (p < 0.001) than in the group that received somatostatin. Eight out of 20 patients in the study group required no additional analgesia intra-operatively. The changes in blood glucose values followed the same pattern in both groups. There was a tendency for liver enzymes to increase in both groups. Although this increase was less in the study group, this change was not statistically significant.

Research paper thumbnail of Negative pressure pulmonary oedema in a patient ventilated with a laryngeal mask

Research paper thumbnail of Successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia

Research paper thumbnail of The effect of ondansetron on postoperative delirium and cognitive function in aged orthopedic patients

Minerva anestesiologica

Background: Postoperative delirium and cognitive dysfunction are common in hospitalized patients.... more Background: Postoperative delirium and cognitive dysfunction are common in hospitalized patients. The aim of this study was to investigate whether postoperative ondansetron administration has a favorable effect on postoperative delirium and 30th day cognitive function and pain in patients undergoing surgery with general anaesthesia due to femoral or hip fracture. Methods: A hundred and six patients aged > 40 years old scheduled for a femoral or hip fracture rehabilitation surgery, were randomized on a double-blind protocol to receive postoperatively 4 ml of either ondansetron 8 mg (Group A) or placebo (Group B) daily i.v. for five days. Each patient was evaluated preoperatively and on the 2nd, 3rd, 4th and 5th day postoperatively with Confusion Assessment Method test, and preoperatively and on the 30th day postoperatively using a sensitive battery of neuropsychological, functional and pain tests. Results: Patients of both groups did not differ preoperatively significantly in thei...

Research paper thumbnail of Imaging of acute aortic syndrome: advantages, disadvantages and pitfalls

Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē

Research paper thumbnail of Surgical management of cardiac implantable electronic device infections

Journal of thoracic disease, 2014

The infection of cardiac implantable electronic devices (CIED) is a serious and potentially letha... more The infection of cardiac implantable electronic devices (CIED) is a serious and potentially lethal complication. The population at risk is growing, as the device implantation is increasing especially in older patients with associated comorbid conditions. Our purpose was to present the management of this complicated surgical condition and to extract the relevant conclusions. During a 3-year period 1,508 CIED were implanted in our hospital. We treated six cases of permanent pacemaker infection with localized pocket infection or endocarditis. In accordance to the recent AHA/ACC guidelines, complete device removal was decided in all cases. The devices were removed under general anaesthesia, with a midline sternotomy, under extracorporeal circulation on the beating heart. Epicardial permanent pacing electrodes were placed on the right atrium and ventricle before the end of the procedure. The postoperative course of all patients was uncomplicated and after a follow up period of five years...

Research paper thumbnail of P-66 Pleasure travelling road traffic accidents in Crete

Research paper thumbnail of Continuous Spinal Anesthesia/Analgesia for Perioperative Management of Morbidly Obese Patients Undergoing Laparotomy for Gastroplastic Surgery

Research paper thumbnail of Effects of Weight Loss on QT Interval in Morbidly Obese Patients

Research paper thumbnail of Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents

Journal of Anesthesia, 2011

The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-h... more The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-hydroxytryptamine type 3 antagonists in terms of the incidence and intensity of postoperative nausea and vomiting (PONV) in a homogenous group of female patients undergoing thyroidectomy. The study cohort consisted of 203 American Society of Anesthesiologists PS I-II female patients randomized into four groups to receive at induction of anesthesia an intravenous (IV) bolus of 5 ml solution of one of the following: normal saline (placebo), granisetron 3 mg, ondansetron 4 mg, or tropisetron 5 mg. Nausea and vomiting were evaluated at five time points: during the first hour in the postanesthesia care unit (PACU) and 6, 12, 18, and 24 h postoperatively. Nausea intensity was measured using a visual analogue scale score (0-10). Patients in the placebo group displayed a high incidence of nausea in the PACU and at 6, 12, and 18 h postoperatively (44, 60, 50, and 34%, respectively) and of vomiting (26, 42, 30 and 10%). The administration of granisetron reduced significantly the incidence of nausea at 6, 12, and 18 h (26, 18, and 2%, respectively) and vomiting at 6 and 12 h (10 and 6%, respectively). Ondansetron reduced significantly the incidence of nausea and vomiting only at 6 h postoperatively (28 and 12%, respectively). The administration of tropisetron did not affect the incidence of PONV compared to placebo. Among the female patients of this study undergoing thyroid surgery, granisetron 3 mg provided the best prophylaxis from PONV. Ondansetron 4 mg was equally effective, but its action lasted only 6 h, whereas tropisetron 5 mg was found ineffective.

Research paper thumbnail of Use of the BIS index in order to describe equipotent doses of sevoflurane and propofol during N2O/remifentanil anaesthesia

European Journal of Anaesthesiology, 2001

Research paper thumbnail of The magnitude of economy in anaesthetic gases with low flow anaesthesia

European Journal of Anaesthesiology, 2001

Research paper thumbnail of Effects of halothane or sevoflurane on QTc dispersion during volatile induction of anaesthesia in children

European Journal of Anaesthesiology, 2000

Research paper thumbnail of The effect of ketanime on heart rate variability during anaesthesia with propofol and alfentanil

European Journal of Anaesthesiology, 2000

Research paper thumbnail of Monitoring the successful embolization of an arterio-venous fistula by a fibreoptic jugular vein catheter

European Journal of Anaesthesiology, 2000

The management of surgical embolization of a post-traumatic carotid-cavernous fistula is reported... more The management of surgical embolization of a post-traumatic carotid-cavernous fistula is reported in this study. The procedure was successfully performed with the aid of a fibreoptic intravascular catheter, which was monitoring continuously the changes of the jugular venous oxygen saturation. Jugular venous oxygen saturation monitoring effectively confirmed the success of embolization without the need for intraoperative angiography, by manifesting an abrupt return of oxygen saturation from arterial to normal venous values immediately after embolization.

Research paper thumbnail of Continuous spinal anaesthesia/analgesia for the perioperative management of high-risk patients

European Journal of Anaesthesiology, 2000

The intraoperative effects of continuous spinal anaesthesia, and the efficacy of postoperative co... more The intraoperative effects of continuous spinal anaesthesia, and the efficacy of postoperative continuous spinal analgesia in 48 elderly high risk patients undergoing major abdominal, vascular or orthopaedic surgery is reported. Intraoperative anaesthetic technique proved to be safe and provided satisfactory results in the immediate postoperative period. Furthermore, the postoperative analgesic regimen which involved intrathecal fentanyl and bupivacaine, and intravenous tenoxicam, provided effective analgesia for all patients. The intrathecal analgesic regimen was administered continuously through a PCA pump which had the facility to provide bolus doses when requested in predetermined lockout intervals. The mean doses of fentanyl and bupivacaine infused intrathecally for the first 24 h postoperatively were 14.5 +/- 1.5 microg h(-1) (mean +/- SD) and 0.72 +/- 0.08 mg h(-1) (mean +/- SD), respectively, while the requirements for analgesia decreased progressively overtime but lasted for 118 h. The technique provided effective analgesia with low pain scores that was reflected by the ease in performing physical exercises and the pleasant co-operation with the physiotherapist. Only minor complications related to anaesthesia/analgesia were encountered.

Research paper thumbnail of Continuous spinal anaesthesia/analgesia for abdominal aortic aneurysm repair and post-operative pain management

European Journal of Anaesthesiology, 1999

The intra-operative management of two patients with chronic obstructive pulmonary disease and car... more The intra-operative management of two patients with chronic obstructive pulmonary disease and cardiovascular pathology, who underwent peripheral reconstructive vascular surgery under continuous spinal anaesthesia, is described. Furthermore, continuous intrathecal analgesia was also continued in the post-operative period and provided effective pain relief that was reflected by the favourable surgical outcome.

Research paper thumbnail of Postoperative hypoxaemia in a patient with patent foramen ovale

European Journal of Anaesthesiology, 2002

EDITOR: The foramen ovale between the two atria, which nor-mally closes soon after delivery, reta... more EDITOR: The foramen ovale between the two atria, which nor-mally closes soon after delivery, retains some patency in 14.6% of people [1]. Some circumstances, such as pulmonary arterial hypertension, favour its reopen-ing. Reopening could be triggered, for example, ...

Research paper thumbnail of Impact of metabolic syndrome in surgical patients: should we bother?: Table 1

British Journal of Anaesthesia, 2015

ABSTRACT

Research paper thumbnail of Anaesthesia and the QT interval. Effects of isoflurane and halothane in unpremedicated children

Research paper thumbnail of Somatostatin and total intravenous anaesthesia. Assessment of analgesic requirements during surgery and the effects on liver enzymes

Anaesthesia

We have studied the analgesic effects of somatostatin during surgery and its influence on the pla... more We have studied the analgesic effects of somatostatin during surgery and its influence on the plasma glucose levels and the liver enzyme profile in 40 ASA 1 or 2 patients undergoing surgery for carcinoma of the gastrointestinal tract. Each patient received either somatostatin bolus 3.5 micrograms.kg-1 intravenously plus an infusion of somatostatin 3.5 micrograms.kg-1.h-1, or sodium chloride 0.9% as a placebo in a double-blind manner. Anaesthesia was induced with propofol 1 mg.kg-1 followed by a continuous infusion of propofol in a stepwise declining regimen. Vecuronium was used for muscular relaxation. Fentanyl 100 micrograms was administered intravenously in bolus doses for analgesia during surgery as required. Blood samples were taken at 10 min pre-induction, 5 min postintubation, 5, 30, 60, 120 min postincision and 30 min post-recovery for plasma glucose levels. Blood samples were also taken at 10 min pre-induction, 120 min postincision and 24 h postoperatively for liver enzymes. The total requirement for fentanyl in the control group was significantly higher (p < 0.001) than in the group that received somatostatin. Eight out of 20 patients in the study group required no additional analgesia intra-operatively. The changes in blood glucose values followed the same pattern in both groups. There was a tendency for liver enzymes to increase in both groups. Although this increase was less in the study group, this change was not statistically significant.

Research paper thumbnail of Negative pressure pulmonary oedema in a patient ventilated with a laryngeal mask

Research paper thumbnail of Successful cardiac and cerebral resuscitation with extracorporeal circulation and mild hypothermia

Research paper thumbnail of The effect of ondansetron on postoperative delirium and cognitive function in aged orthopedic patients

Minerva anestesiologica

Background: Postoperative delirium and cognitive dysfunction are common in hospitalized patients.... more Background: Postoperative delirium and cognitive dysfunction are common in hospitalized patients. The aim of this study was to investigate whether postoperative ondansetron administration has a favorable effect on postoperative delirium and 30th day cognitive function and pain in patients undergoing surgery with general anaesthesia due to femoral or hip fracture. Methods: A hundred and six patients aged > 40 years old scheduled for a femoral or hip fracture rehabilitation surgery, were randomized on a double-blind protocol to receive postoperatively 4 ml of either ondansetron 8 mg (Group A) or placebo (Group B) daily i.v. for five days. Each patient was evaluated preoperatively and on the 2nd, 3rd, 4th and 5th day postoperatively with Confusion Assessment Method test, and preoperatively and on the 30th day postoperatively using a sensitive battery of neuropsychological, functional and pain tests. Results: Patients of both groups did not differ preoperatively significantly in thei...

Research paper thumbnail of Imaging of acute aortic syndrome: advantages, disadvantages and pitfalls

Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē

Research paper thumbnail of Surgical management of cardiac implantable electronic device infections

Journal of thoracic disease, 2014

The infection of cardiac implantable electronic devices (CIED) is a serious and potentially letha... more The infection of cardiac implantable electronic devices (CIED) is a serious and potentially lethal complication. The population at risk is growing, as the device implantation is increasing especially in older patients with associated comorbid conditions. Our purpose was to present the management of this complicated surgical condition and to extract the relevant conclusions. During a 3-year period 1,508 CIED were implanted in our hospital. We treated six cases of permanent pacemaker infection with localized pocket infection or endocarditis. In accordance to the recent AHA/ACC guidelines, complete device removal was decided in all cases. The devices were removed under general anaesthesia, with a midline sternotomy, under extracorporeal circulation on the beating heart. Epicardial permanent pacing electrodes were placed on the right atrium and ventricle before the end of the procedure. The postoperative course of all patients was uncomplicated and after a follow up period of five years...

Research paper thumbnail of P-66 Pleasure travelling road traffic accidents in Crete

Research paper thumbnail of Continuous Spinal Anesthesia/Analgesia for Perioperative Management of Morbidly Obese Patients Undergoing Laparotomy for Gastroplastic Surgery

Research paper thumbnail of Effects of Weight Loss on QT Interval in Morbidly Obese Patients

Research paper thumbnail of Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents

Journal of Anesthesia, 2011

The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-h... more The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-hydroxytryptamine type 3 antagonists in terms of the incidence and intensity of postoperative nausea and vomiting (PONV) in a homogenous group of female patients undergoing thyroidectomy. The study cohort consisted of 203 American Society of Anesthesiologists PS I-II female patients randomized into four groups to receive at induction of anesthesia an intravenous (IV) bolus of 5 ml solution of one of the following: normal saline (placebo), granisetron 3 mg, ondansetron 4 mg, or tropisetron 5 mg. Nausea and vomiting were evaluated at five time points: during the first hour in the postanesthesia care unit (PACU) and 6, 12, 18, and 24 h postoperatively. Nausea intensity was measured using a visual analogue scale score (0-10). Patients in the placebo group displayed a high incidence of nausea in the PACU and at 6, 12, and 18 h postoperatively (44, 60, 50, and 34%, respectively) and of vomiting (26, 42, 30 and 10%). The administration of granisetron reduced significantly the incidence of nausea at 6, 12, and 18 h (26, 18, and 2%, respectively) and vomiting at 6 and 12 h (10 and 6%, respectively). Ondansetron reduced significantly the incidence of nausea and vomiting only at 6 h postoperatively (28 and 12%, respectively). The administration of tropisetron did not affect the incidence of PONV compared to placebo. Among the female patients of this study undergoing thyroid surgery, granisetron 3 mg provided the best prophylaxis from PONV. Ondansetron 4 mg was equally effective, but its action lasted only 6 h, whereas tropisetron 5 mg was found ineffective.

Research paper thumbnail of Use of the BIS index in order to describe equipotent doses of sevoflurane and propofol during N2O/remifentanil anaesthesia

European Journal of Anaesthesiology, 2001

Research paper thumbnail of The magnitude of economy in anaesthetic gases with low flow anaesthesia

European Journal of Anaesthesiology, 2001

Research paper thumbnail of Effects of halothane or sevoflurane on QTc dispersion during volatile induction of anaesthesia in children

European Journal of Anaesthesiology, 2000

Research paper thumbnail of The effect of ketanime on heart rate variability during anaesthesia with propofol and alfentanil

European Journal of Anaesthesiology, 2000

Research paper thumbnail of Monitoring the successful embolization of an arterio-venous fistula by a fibreoptic jugular vein catheter

European Journal of Anaesthesiology, 2000

The management of surgical embolization of a post-traumatic carotid-cavernous fistula is reported... more The management of surgical embolization of a post-traumatic carotid-cavernous fistula is reported in this study. The procedure was successfully performed with the aid of a fibreoptic intravascular catheter, which was monitoring continuously the changes of the jugular venous oxygen saturation. Jugular venous oxygen saturation monitoring effectively confirmed the success of embolization without the need for intraoperative angiography, by manifesting an abrupt return of oxygen saturation from arterial to normal venous values immediately after embolization.

Research paper thumbnail of Continuous spinal anaesthesia/analgesia for the perioperative management of high-risk patients

European Journal of Anaesthesiology, 2000

The intraoperative effects of continuous spinal anaesthesia, and the efficacy of postoperative co... more The intraoperative effects of continuous spinal anaesthesia, and the efficacy of postoperative continuous spinal analgesia in 48 elderly high risk patients undergoing major abdominal, vascular or orthopaedic surgery is reported. Intraoperative anaesthetic technique proved to be safe and provided satisfactory results in the immediate postoperative period. Furthermore, the postoperative analgesic regimen which involved intrathecal fentanyl and bupivacaine, and intravenous tenoxicam, provided effective analgesia for all patients. The intrathecal analgesic regimen was administered continuously through a PCA pump which had the facility to provide bolus doses when requested in predetermined lockout intervals. The mean doses of fentanyl and bupivacaine infused intrathecally for the first 24 h postoperatively were 14.5 +/- 1.5 microg h(-1) (mean +/- SD) and 0.72 +/- 0.08 mg h(-1) (mean +/- SD), respectively, while the requirements for analgesia decreased progressively overtime but lasted for 118 h. The technique provided effective analgesia with low pain scores that was reflected by the ease in performing physical exercises and the pleasant co-operation with the physiotherapist. Only minor complications related to anaesthesia/analgesia were encountered.

Research paper thumbnail of Continuous spinal anaesthesia/analgesia for abdominal aortic aneurysm repair and post-operative pain management

European Journal of Anaesthesiology, 1999

The intra-operative management of two patients with chronic obstructive pulmonary disease and car... more The intra-operative management of two patients with chronic obstructive pulmonary disease and cardiovascular pathology, who underwent peripheral reconstructive vascular surgery under continuous spinal anaesthesia, is described. Furthermore, continuous intrathecal analgesia was also continued in the post-operative period and provided effective pain relief that was reflected by the favourable surgical outcome.

Research paper thumbnail of Postoperative hypoxaemia in a patient with patent foramen ovale

European Journal of Anaesthesiology, 2002

EDITOR: The foramen ovale between the two atria, which nor-mally closes soon after delivery, reta... more EDITOR: The foramen ovale between the two atria, which nor-mally closes soon after delivery, retains some patency in 14.6% of people [1]. Some circumstances, such as pulmonary arterial hypertension, favour its reopen-ing. Reopening could be triggered, for example, ...