G. Capogna - Academia.edu (original) (raw)
Papers by G. Capogna
Minerva anestesiologica
A new type of 10% lipidic emulsion based on safflower oil and soya (Liposyn II, Abbott, Latina) c... more A new type of 10% lipidic emulsion based on safflower oil and soya (Liposyn II, Abbott, Latina) characterised by a high linoleic/linolenic acid ratio was administered in random, double blind fashion with 10% Intralipid to 20 subjects submitted to major surgery of the digestive system. Dosage was 1.2 g/kg at an infusion rate of 2.6 ml/kg/h. In order to evidence possible in vivo inter-reactions between proteins of the acute post-aggressive phase and these emulsions, serial samples were used to measure haemogasanalytic parameters, plasma levels of triglycerides and serum levels of protein C-reactive and fourth complement factor. Both emulsions proved well tolerated and there was no evidence of general or administrative site reactions. The plasma levels of triglycerides underwent an increase during the test, with no significant differences between the two groups of patients. Notwithstanding the high serum levels of protein C-reactive of the subjects in question, there was no evidence of...
F1000 - Post-publication peer review of the biomedical literature, 2008
This is a review of the most important articles of Minerva Anestesiologica of 201
Minerva Anestesiologica, 1991
Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in... more Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group D, n = 7) for a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before 90, 150, 480 minutes after the subarachnoid injection. In group A mild pruritus and sedation occurred in 5 patients, nausea, vomiting and periodic breathing occurred in 2 patients. In group B mild pruritus and sedation were observed in 4 patients, nausea, vomiting in 2 patients. No significant changes in VE, Vt/Ti and Ti/Ttot were observed between the groups. Patients receiving 50 micrograms of fentanyl showed a slope VE/PET CO2 significantly below baseline values at 90 and 150 minutes (p less than 0.05). In this group the baseline values were restored ...
Regional Anesthesia & Pain Medicine, 1994
Background and Objectives. A number of clinical studies have been performed in an attempt to esta... more Background and Objectives. A number of clinical studies have been performed in an attempt to establish the effects of alkalinization on potency of local anesthetics. Conflicting results were obtained probably because different studies used different methods as well as different definitions of the effects. To determine the efficacy of alkalinization using different local anesthetic solutions and different regional blocks, 180 patients were studied in a randomized, double-blind fashion. The local anesthetic solutions studied were bupivacaine, mepivacaine, and lidocaine; the regional blocks studied were epidural block, axillary brachial plexus block, and femoral and sciatic nerve block. Materials and Methods. In this study, 180 patients receiving epidural block (n = 60), sciatic and femoral nerve block (n = 60), and brachial plexus block (n = 60) were randomized to receive, in a double-blind fashion, a plain or a pH-adjusted solution of 2% mepivacaine, 2% lidocaine, or 0.5% bupivacaine...
Minerva anestesiologica, 2001
BACKGROUND The aim of this study was to determine the ED50 for the dose of levobupivacaine 0,5% t... more BACKGROUND The aim of this study was to determine the ED50 for the dose of levobupivacaine 0,5% that, if given intrathecally will not cause total spinal anesthesia but will give a reliable and reproducible clinical sign to differentiate intrathecal from epidural injection. METHODS Thirty women at term undergoing elective cesarean section under a combined spinal-epidural technique (CSE) were enrolled into this sequential allocation study. The dose in each test dose was determined by the response of the previous patient to the higher or lower dose in her test syringe, according to up-down sequential allocation. The exception to this was the first woman in each group, for whom the starting dose was chosen to be 4 mg. The end point was the occurrence of any motor block, in any side, within 5 minutes from intrathecal injection of the test dose. Test dose efficacy was assessed using a modified Bromage scale every minute for 5 minutes. The median effective dose of levobupivacaine was estim...
International Journal of Obstetric Anesthesia, 1997
Journal of Clinical Anesthesia, 1993
Background and Objectives The randomized, double-blind, dose-response study was designed to evalu... more Background and Objectives The randomized, double-blind, dose-response study was designed to evaluate the effects of the addition of clonidine to epidural morphine on postoperative analgesia and side effects in patients undergoing cesarean delivery. Methods Sixty patients, undergoing cesarean delivery under epidural anesthesia, were randomly divided in three equal groups to receive, at the end of surgery, an epidural analgesic mixture consisting of 10 mL solution containing 2 mg of morphine diluted with 0.125% bupivacaine plus 1:800,000 epinephrine and 0, 75, or 150 μg of clonidine. Duration of analgesia was assessed as the pain-free interval between the end of surgery and patient’s first analgesic request. The analgesic mixture was repeated, on patient’s request, to 36 hours after the operation. Arterial blood pressure, heart rate, respiratory rate, and side effects were noted. The total amount of morphine and clonidine delivered was also noted. Results The addition of clonidine (0,...
Minerva Anestesiologica, 2014
We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. T... more We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both g...
Minerva Anestesiologica, 2012
Minerva Anestesiologica, 2001
All epidural or spinal techniques using local anaesthetics causes some degree of sympathetic bloc... more All epidural or spinal techniques using local anaesthetics causes some degree of sympathetic blockade resulting in peripheral vasodilatation and possibly hypotension or reduction in cardiac output. In the practical clinic, administration of fluids intravenously prior spinal and epidural anaesthesia is required to prevent maternal hypotension and fetal hypoxia. We evaluated in this review the efficacy of volume preloading on the incidence of hypotension after spinal or epidural anaesthesia for caesarean delivery. Randomized controlled trials investigating volume preloading before the initiation of obstetric anaesthesia were sought by using MEDLINE (1966-2001). The primary outcome was the incidence of hypotension. Secondary outcomes included: ephedrine use, Apgar scores, umbilical cord pH values, and maternal nausea and vomiting. Crystalloid preload was inconsistent in preventing hypotension, whereas colloid appeared to be effective in all studies. A colloid solution, such as hydro-xy...
Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 1997
We have studied the efficacy of i.v. clonidine to suppress post-extradural shivering in parturien... more We have studied the efficacy of i.v. clonidine to suppress post-extradural shivering in parturients. Forty healthy parturients who received extradural block for labour (n = 20) or for Caesarean section (n = 20) and who required treatment for shivering after delivery were allocated randomly to two groups. Group I received i. v. clonidine 30 fig diluted in saline to a total volume of 5 ml (therapeutic solution). This bolus was repeated every 5 min if the initial therapy produced no improvement, up to a maximum dose of 90 ng. Group II received saline 5 ml (placebo solution), repeated every 5 min if the initial bolus produced no improvement, up to a maximum of three boluses. After 15 min of obser-vation, patients in group I received the placebo solution and those in group II received the study solution. All patients who received clonidine im-proved, and 75 % ceased to shiver within 5 min after only one dose of clonidine 30 /ig. In contrast, none of the patients treated with saline impro...
Minerva anestesiologica, 2014
BACKGROUND We organized a training program for oral fiber optic intubation (FOI) under conscious ... more BACKGROUND We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. METHODS The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were s...
International Journal of Obstetric Anesthesia
BACKGROUND This prospective study was designed to validate the CompuFlo® device and to assess its... more BACKGROUND This prospective study was designed to validate the CompuFlo® device and to assess its use in difficult epidural placement. METHODS In the first part of the study, 30 parturients requesting labor epidural analgesia were recruited. The block was performed by an expert anesthesiologist, with the Tuohy needle connected to the CompuFlo® device to evaluate the agreement between the anesthesiologist's reported sensation and the variation of pressure recorded by the CompuFlo®. In the second part of the study, 56 consecutive parturients, for whom at least two complete needle reinsertions were made by trainees during epidural placement for labor analgesia, were enrolled. CompuFlo® was used as a rescue tool for the subsequent attempt. RESULTS In all cases epidural analgesia was successful and no complications were noted. There was a good correlation between the operator's feelings and the delta of pressure recorded by the CompuFlo®, for both identification of the ligamentum flavum and of the epidural space (Rho = 0.79; tau = 0.67). In the second part of the study, all the difficult blocks performed with the CompuFlo® were successful after a single attempt. The pressure curves of false loss-of-resistance were significantly different from the true loss-of-resistance (P <0.0001) DISCUSSION: CompuFlo® was validated as a tool to identify the epidural space. It may also assist trainees in successful epidural placement in difficult cases.
European Journal of Anaesthesiology
... Alston 17/08/2005 Apfel 28/10/2005 Arvieux 24/08/2005 Askitopoulou 20/08/2005 Avidan 23/06/20... more ... Alston 17/08/2005 Apfel 28/10/2005 Arvieux 24/08/2005 Askitopoulou 20/08/2005 Avidan 23/06/2005 Badner 19/09/2005 Bailey 05/02 ... 2005 Ummenhofer 09/09/2005 Unertl 03/06/2005 Valero 09/26/2005 van Gessel 03/30/2005 Vercauteren 04/21/2005 Viby-Mogensen 06/07 ...
Minerva anestesiologica
A new type of 10% lipidic emulsion based on safflower oil and soya (Liposyn II, Abbott, Latina) c... more A new type of 10% lipidic emulsion based on safflower oil and soya (Liposyn II, Abbott, Latina) characterised by a high linoleic/linolenic acid ratio was administered in random, double blind fashion with 10% Intralipid to 20 subjects submitted to major surgery of the digestive system. Dosage was 1.2 g/kg at an infusion rate of 2.6 ml/kg/h. In order to evidence possible in vivo inter-reactions between proteins of the acute post-aggressive phase and these emulsions, serial samples were used to measure haemogasanalytic parameters, plasma levels of triglycerides and serum levels of protein C-reactive and fourth complement factor. Both emulsions proved well tolerated and there was no evidence of general or administrative site reactions. The plasma levels of triglycerides underwent an increase during the test, with no significant differences between the two groups of patients. Notwithstanding the high serum levels of protein C-reactive of the subjects in question, there was no evidence of...
F1000 - Post-publication peer review of the biomedical literature, 2008
This is a review of the most important articles of Minerva Anestesiologica of 201
Minerva Anestesiologica, 1991
Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in... more Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group D, n = 7) for a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before 90, 150, 480 minutes after the subarachnoid injection. In group A mild pruritus and sedation occurred in 5 patients, nausea, vomiting and periodic breathing occurred in 2 patients. In group B mild pruritus and sedation were observed in 4 patients, nausea, vomiting in 2 patients. No significant changes in VE, Vt/Ti and Ti/Ttot were observed between the groups. Patients receiving 50 micrograms of fentanyl showed a slope VE/PET CO2 significantly below baseline values at 90 and 150 minutes (p less than 0.05). In this group the baseline values were restored ...
Regional Anesthesia & Pain Medicine, 1994
Background and Objectives. A number of clinical studies have been performed in an attempt to esta... more Background and Objectives. A number of clinical studies have been performed in an attempt to establish the effects of alkalinization on potency of local anesthetics. Conflicting results were obtained probably because different studies used different methods as well as different definitions of the effects. To determine the efficacy of alkalinization using different local anesthetic solutions and different regional blocks, 180 patients were studied in a randomized, double-blind fashion. The local anesthetic solutions studied were bupivacaine, mepivacaine, and lidocaine; the regional blocks studied were epidural block, axillary brachial plexus block, and femoral and sciatic nerve block. Materials and Methods. In this study, 180 patients receiving epidural block (n = 60), sciatic and femoral nerve block (n = 60), and brachial plexus block (n = 60) were randomized to receive, in a double-blind fashion, a plain or a pH-adjusted solution of 2% mepivacaine, 2% lidocaine, or 0.5% bupivacaine...
Minerva anestesiologica, 2001
BACKGROUND The aim of this study was to determine the ED50 for the dose of levobupivacaine 0,5% t... more BACKGROUND The aim of this study was to determine the ED50 for the dose of levobupivacaine 0,5% that, if given intrathecally will not cause total spinal anesthesia but will give a reliable and reproducible clinical sign to differentiate intrathecal from epidural injection. METHODS Thirty women at term undergoing elective cesarean section under a combined spinal-epidural technique (CSE) were enrolled into this sequential allocation study. The dose in each test dose was determined by the response of the previous patient to the higher or lower dose in her test syringe, according to up-down sequential allocation. The exception to this was the first woman in each group, for whom the starting dose was chosen to be 4 mg. The end point was the occurrence of any motor block, in any side, within 5 minutes from intrathecal injection of the test dose. Test dose efficacy was assessed using a modified Bromage scale every minute for 5 minutes. The median effective dose of levobupivacaine was estim...
International Journal of Obstetric Anesthesia, 1997
Journal of Clinical Anesthesia, 1993
Background and Objectives The randomized, double-blind, dose-response study was designed to evalu... more Background and Objectives The randomized, double-blind, dose-response study was designed to evaluate the effects of the addition of clonidine to epidural morphine on postoperative analgesia and side effects in patients undergoing cesarean delivery. Methods Sixty patients, undergoing cesarean delivery under epidural anesthesia, were randomly divided in three equal groups to receive, at the end of surgery, an epidural analgesic mixture consisting of 10 mL solution containing 2 mg of morphine diluted with 0.125% bupivacaine plus 1:800,000 epinephrine and 0, 75, or 150 μg of clonidine. Duration of analgesia was assessed as the pain-free interval between the end of surgery and patient’s first analgesic request. The analgesic mixture was repeated, on patient’s request, to 36 hours after the operation. Arterial blood pressure, heart rate, respiratory rate, and side effects were noted. The total amount of morphine and clonidine delivered was also noted. Results The addition of clonidine (0,...
Minerva Anestesiologica, 2014
We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. T... more We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were successful in both g...
Minerva Anestesiologica, 2012
Minerva Anestesiologica, 2001
All epidural or spinal techniques using local anaesthetics causes some degree of sympathetic bloc... more All epidural or spinal techniques using local anaesthetics causes some degree of sympathetic blockade resulting in peripheral vasodilatation and possibly hypotension or reduction in cardiac output. In the practical clinic, administration of fluids intravenously prior spinal and epidural anaesthesia is required to prevent maternal hypotension and fetal hypoxia. We evaluated in this review the efficacy of volume preloading on the incidence of hypotension after spinal or epidural anaesthesia for caesarean delivery. Randomized controlled trials investigating volume preloading before the initiation of obstetric anaesthesia were sought by using MEDLINE (1966-2001). The primary outcome was the incidence of hypotension. Secondary outcomes included: ephedrine use, Apgar scores, umbilical cord pH values, and maternal nausea and vomiting. Crystalloid preload was inconsistent in preventing hypotension, whereas colloid appeared to be effective in all studies. A colloid solution, such as hydro-xy...
Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 1997
We have studied the efficacy of i.v. clonidine to suppress post-extradural shivering in parturien... more We have studied the efficacy of i.v. clonidine to suppress post-extradural shivering in parturients. Forty healthy parturients who received extradural block for labour (n = 20) or for Caesarean section (n = 20) and who required treatment for shivering after delivery were allocated randomly to two groups. Group I received i. v. clonidine 30 fig diluted in saline to a total volume of 5 ml (therapeutic solution). This bolus was repeated every 5 min if the initial therapy produced no improvement, up to a maximum dose of 90 ng. Group II received saline 5 ml (placebo solution), repeated every 5 min if the initial bolus produced no improvement, up to a maximum of three boluses. After 15 min of obser-vation, patients in group I received the placebo solution and those in group II received the study solution. All patients who received clonidine im-proved, and 75 % ceased to shiver within 5 min after only one dose of clonidine 30 /ig. In contrast, none of the patients treated with saline impro...
Minerva anestesiologica, 2014
BACKGROUND We organized a training program for oral fiber optic intubation (FOI) under conscious ... more BACKGROUND We organized a training program for oral fiber optic intubation (FOI) under conscious sedation. The efficacy of the program was evaluated by comparing the performances of experts and novices. METHODS The training procedure was divided into two sessions: a theoretical session on difficult airways, the fiber optic bronchoscope (FOB), remifentanil, topical anesthesia and patient interactions; and a session involving simulations of the FOI technique on dummies. For in vivo FOI, we enrolled patients requiring orotracheal intubation for elective surgery. Electrocardiograms, mean arterial pressure was railroaded over the fiberscope, and tracheal intubati6 and 7) FOIs, respectively, joined the study. To reach ±23 bpm, P=0.02), and RR was decreased (from 16±3 to 12±4 bpm, P<0.05). No differences were recorded between the experts and less-experienced anesthesiologists. The average duration of FOI was 3.3±2.0 min for experts and 4.2±2.4 min for novices (P=0.03). Procedures were s...
International Journal of Obstetric Anesthesia
BACKGROUND This prospective study was designed to validate the CompuFlo® device and to assess its... more BACKGROUND This prospective study was designed to validate the CompuFlo® device and to assess its use in difficult epidural placement. METHODS In the first part of the study, 30 parturients requesting labor epidural analgesia were recruited. The block was performed by an expert anesthesiologist, with the Tuohy needle connected to the CompuFlo® device to evaluate the agreement between the anesthesiologist's reported sensation and the variation of pressure recorded by the CompuFlo®. In the second part of the study, 56 consecutive parturients, for whom at least two complete needle reinsertions were made by trainees during epidural placement for labor analgesia, were enrolled. CompuFlo® was used as a rescue tool for the subsequent attempt. RESULTS In all cases epidural analgesia was successful and no complications were noted. There was a good correlation between the operator's feelings and the delta of pressure recorded by the CompuFlo®, for both identification of the ligamentum flavum and of the epidural space (Rho = 0.79; tau = 0.67). In the second part of the study, all the difficult blocks performed with the CompuFlo® were successful after a single attempt. The pressure curves of false loss-of-resistance were significantly different from the true loss-of-resistance (P <0.0001) DISCUSSION: CompuFlo® was validated as a tool to identify the epidural space. It may also assist trainees in successful epidural placement in difficult cases.
European Journal of Anaesthesiology
... Alston 17/08/2005 Apfel 28/10/2005 Arvieux 24/08/2005 Askitopoulou 20/08/2005 Avidan 23/06/20... more ... Alston 17/08/2005 Apfel 28/10/2005 Arvieux 24/08/2005 Askitopoulou 20/08/2005 Avidan 23/06/2005 Badner 19/09/2005 Bailey 05/02 ... 2005 Ummenhofer 09/09/2005 Unertl 03/06/2005 Valero 09/26/2005 van Gessel 03/30/2005 Vercauteren 04/21/2005 Viby-Mogensen 06/07 ...