Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients undergoing surgery under regional anaesthesia often prefer to be sedated and do not later want to recall the procedure. One hundred and twenty-one patients scheduled for various surgical procedures under epidural, spinal, sacral, or brachial plexus blockades received 1 mg/kg of pethidine, 0.007 mg/kg of scopolamine, plus 0.14 mg/kg of morphine, or 0.03 mg/kg or 0.06 mg/kg or lorazepam intramuscularly as preanaesthetic medication before the operation. The patients's self-assessments of degree of fatigue and apprehension were similar after each premedication when assessed before operation. Postoperative anxiety and confusion as well as need for postoperative care and supervision were greatest after 0.06mg/kg of lorazepam. Significantly (P smaller than 0.05 to P smaller than 0.01) fewer patients given 0.06 mg/kg or lorazepam remembered different events and procedures carried out on them before and after operation than those given other premedications, but no significant differences were noted in patients' ability to recall the performance of operation when asked on the following day. Seventy-seven, 63, and 57% of patients receiving 0.06 mg/kg of lorazepam remembered the start of blockade, performance of operation, and stay in recovery room, respectively. Intravenous sedation should be preferred to these intramuscularly administered premedications if drug-induced amnesia is sought to supplement local anaesthetic techniques.
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PMID:Failure of intramuscularly administered lorazepam and scopolamine-morphine premedication to produce amnesic effects to supplement conduction anaesthesia. 611 Mar 2

Over the years, the depot neuroleptics clopenthixol decanoate, flupentixol decanoate, fluphenazine decanoate and pipotiazine palmitate have prove their excellent tolerance: testing the sensitivity of the patient with the corresponding oral neuroleptic or with a low dose of the injectable form is no more necessary, operative anaesthesia is no more feared. Side-effects are largely due to the fact that the drug is actually taken, as opposed to oral treatments; they consist mainly of drowsiness or tiredness, and of extrapyramidal symptoms (preferably controlled by dexetimide, because of its long duration of action). Among the advantages of depot treatments, the author mentions an increasing motivation to accept medication, because of the reduction of hospitalisations and the fact that the patient is not reminded "three times daily" of his "ill state". Among the disadvantages, he mentions the fear of injection (the alternative being long-acting oral penfluridol), depression (esp. with fluphenazine decanoate) and the fact that the absorption cannot be interrupted in a short time.
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PMID:Experience with depot neuroleptics in ambulatory practice. 611 88

Epidural buprenorphine was investigated as a postoperative analgesic in a randomized double-blind study of 158 patients given epidural analgesia with mepivacaine or bupivacaine for orthopedic surgery of the lower extremity. At the end of surgery, patients were given either 0.15 mg of epidural buprenorphine (n = 38), 0.3 mg (n = 37) in 15-ml saline, or no further epidural injections (n = 47, control group) after 2% mepivacaine for intraoperative anesthesia. A fourth group (n = 36) received 0.3 mg of buprenorphine in 15-ml saline, after the intraoperative use of 0.5% bupivacaine. The patients rated postoperative pain. The need for additional analgesics as well as side effects were recorded. Analgesia after 0.15 mg buprenorphine was superior to that after no reinjection for 6 hr after surgery (P less than 0.05). Buprenorphine (0.3 mg) was superior both to no reinjection and to 0.15 mg of buprenorphine until the twelfth hour (P less than 0.05). Analgesia after bupivacaine followed by 0.3 mg of buprenorphine was not significantly different than analgesia seen after mepivacaine followed by 0.3 mg of buprenorphine. There was an increase of PaCO2 of 2-5 mm Hg between 1.5-3.5 hr after 0.3 mg of buprenorphine without any evidence for late respiratory depression. Other side effects, e.g., disturbances of micturition, pruritus, nausea, vomiting, fatigue, and headache, were comparably common in all groups. The epidural administration of 0.3 mg buprenorphine may be recommended for postoperative analgesia following orthopedic surgery of the lower extremity.
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PMID:Epidural buprenorphine--a double-blind study of postoperative analgesia and side effects. 637 65

The authors present three cases of the rare isolated luxation of the fibular head. Anatomy, injuring mechanism and classification are described. The diagnosis is established by clinical examination and comparative X-ray radiography. If a luxation is irresponsible under general anesthesia (two of our cases), open reposition has to be performed with subsequent temporary nail or screw fixation. A postoperative immobilization with plaster cast on the thigh over a period of six months is necessary. After removal of the plaster cast, the material must immediately be removed in order to avoid complications such as fatigue fractures of the material. If this therapy scheme is observed, surgical treatment can be performed without problems and good functional therapy results will be achieved.
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PMID:[Isolated luxation of the proximal tibio-fibular joint as a rare sports injury]. 665 58

This study determined to what extent the hind limb muscles of hamsters resemble those of other mammals in undergoing changes in physiologic, morphologic, and histochemical properties as a function of age. Maximal isometric twitch and tetanic responses were evoked in soleus and plantaris muscles of hamsters aged 13 days to 6 months; all experiments were conducted in vivo under sodium pentobarbital anesthesia. In keeping with findings in the cat and rat, both hamster muscles had relatively prolonged twitches in the youngest animals; the twitches became briefer during development, that of plantaris having a minimum mean contraction time of 15.4 +/- 2.4 ms at 20 days and that of soleus, 28.3 +/- 3.5 ms at 46 days. In both muscles there was a subsequent slight prolongation of the twitch. The two muscles had similar masses at 13 and 20 days; thereafter the plantaris became considerably larger and stronger than the soleus and developed more tetanic tension per unit cross-sectional area. In keeping with its briefer contraction, plantaris had a more rapid rate of rise of tetanic tension than soleus and was more susceptible to fatigue; whereas the soleus developed depression of the twitch after a tetanus, the plantaris exhibited potentiation. Histological and histochemical studies showed that the plantaris had significantly more muscle fibers than the soleus and a much greater proportion of type II fibers (91 and 39%, respectively, in 120- to 180-day-old animals). Whereas the type II fibers had similar cross-sectional areas in the two muscles, the type I fibers were significantly smaller in plantaris than in soleus.
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PMID:Physiologic and histologic features of muscle development in the hamster. 673 84

A new method for the detection and recording of the oculocardiac reflex (OCR) is described and applied to 49 healthy infants and children (six months to nine years old) undergoing strabismus surgery under halothane anaesthesia with spontaneous ventilation. Eighty-one extraocular muscles were studied. Square wave stimuli (abrupt and sustained tractions) were definitely more reflexogenic than slow slope stimuli (very gradual, progressive and gentle tractions). Vagal escape, as well as fatigue of the OCR, are graphically documented and analysed. In this series, using well-defined and controlled tractions, the medial rectus was not more reflexogenic than the other extraocular muscles. Hypercapnia was an important adjuvant factor of the OCR. Controlled ventilation is recommended. The routine use of intravenous anticholinergic drugs is briefly discussed. Prevention of the OCR, and prophylaxis of cardiac arrhythmias during strabismus surgery, now seem to be placed on a more rational basis.
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PMID:The oculocardiac reflex: a graphic and statistical analysis in infants and children. 687 77

Chronic electrostimulation of the sacral roots induces an increase in urethral resistance due to activation of muscles of the striated urethral sphincter. Histochemical study of the urethral striated musculature (nonstimulated) revealed 3 main varieties of fibers: 1) Slow twitch fibers (35 per cent of the whole muscle); 2) Fast twitch fatiguable fibers (52 per cent); and 3) An intermediate type, fast twitch fatigue resistant (13 per cent). Ten dogs with chronically implanted electrodes at the 2nd sacral root were subjected to a program of prolonged stimulation under anesthesia. After prolonged electrostimulation, we detected hypertrophy of the striated muscle fibers of the urethra, anal sphincter and stimulated side of the tail. The stimulated muscle fibers showed a higher overall oxidative activity than the controls. This occurred both in intact and spinalized animals. We thus expect the urethral striated musculature to be more resistant to fatigue because of the increased oxidative activity. Stimulated fibers also had increased glycolytic activity as shown by the enhanced intermyofibrillar deposition, especially in the fast twitch fibers. The increased glycolytic activity may also increase fatigue resistance by producing energy during periods of low oxygen supply at the peak of muscular contraction. As a consequence of increase in oxidative and glycolytic capacities and muscular hypertrophy, we expect that the striated musculature of the urethra will be not only more resistant to fatigue but also capable of generating higher tension. Both are important in achieving continence via electrostimulation of sacral nerve roots. Approximately 3 months after conclusion of the stimulation program these changes had gradually reverted to the normal prestimulation level.
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PMID:Effect of chronic electrostimulation of the sacral roots on the striated urethral sphincter. 715 9

Postoperative analgesia and the side effects of epidurally injected morphine were investigated in a double-blind study. Following lumbar epidural anesthesia for orthopedic operations, 174 patients received, in a randomized, double-blind fashion, either 0.1 mg/kg of morphine epidurally, 0.1 mg/kg of morphine intramuscularly, or saline epidurally at the end of surgery. Following epidural morphine, postoperative pain was les frequent, less intense and of shorter duration, use of analgesics and sedative was less frequent; and the postoperative feeling of well-being rated better than after systemic morphine or epidural saline. These effects were more frequent when bupivacaine was used for operative epidural anesthesia than when mepivacaine was used. The results were age independent. Side effects following epidural morphine included pruritus and disturbances of micturition. Nausea, vomiting, fatigue, and headache were of comparable frequency in the three groups.
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PMID:Epidural morphine for postoperative analgesia: a double-blind study. 719 36

1. The afferent responses evoked by mechanical and thermal stimulation of the cat cornea were recorded extracellularly from strands of long and mixed ciliary nerves under deep anaesthesia. 94% of the units studied (n = 53) responded consistently to both stimuli. 2. Conduction velocities, measured by electrical stimulation of the receptive field, corresponded to the lower range of the A-delta fibre group (average = 5.4 m/sec). Receptive fields covered approximately a quadrant of the corneal surface and showed continuous sensitivity and overlapping. Units were silent in the absence of stimulation but an ongoing activity was commonly present after repeated mechanical and thermal stimulation. 3. Mechanical responses were evoked at low thresholds and consisted of a dynamic and static response that paralleled the amplitude of the stimulus. The pattern of the discharge was irregular and fatigue was easily developed by repeated stimulation. 4. Thresholds to heating were above 38 degrees C and the response increased monotonically with the temperature over the range from threshold to 50 degrees C. The heat response could be sensitized by repeated long suprathreshold stimulation while variable changes in the response were induced by briefer stimuli. Also depression was observed in some circumstances. A weak response to cooling was present in 50% of the units tested. 5. Damaging mechanical stimulation or the application of a strong acid solution evoked a vigorous response followed by an earlier discharge that persisted for hours. 6. The relation of these receptors to other polymodal nociceptors and corneal sensation is considered.
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PMID:Responses of cat corneal sensory receptors to mechanical and thermal stimulation. 733 16

Adult male rats were exposed to 3.8-km altitude for intervals ranging from 1 h-60 d. Liver samples were taken under light ether anesthesia and were examined by enzymatic analyses. Within 1-6 h of hypoxic exposure, ATP levels decreased while ADP and AMP levels increased, producing a fall in calculated ATP/ADP and adenylate charge ratios. Concurrently, lactate/pyruvate and alpha-glycerophosphate/dihydroxyacetone phosphate ratios increased markedly. Direct measurements of cellular pyridine nucleotides indicated increased NADH/NAD and NADPH/NADP ratios. Levels of total adenosine phosphates and pyridine nucleotides decreased in a significant accompanying response. Many metabolite levels and calculated ratios returned to near-normal values within 1 week of exposure, indicating secondary intracellular adjustments to hypoxic stress; however, persistence of that stress is reflected in lactate concentrations and both substrate redox ratios. Results support and explore concepts that increased oxidation-reduction status and decreased energy status are primary events during hypoxia.
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PMID:Energy status and oxidation-reduction status in rat liver at high altitude (3.8 km). 738 68


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