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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was designed to see whether covering of the eyes during and after ketamine anaesthesia would reduce the incidence of dreams. One hundred and fifty patients, randomly divided into three groups, underwent therapeutic abortion with ketamine as the sole anaesthesia. One hundred patients had their eyes completely covered, 50 in the operating room only and 50 in the operating room and in the recovery room. The third 50 were controls, with their eyes uncovered. All patients were questioned post-operatively about dreams, nausea and vomiting, headache, dizziness and experiences, and also how frequently they dreamed at home. Although covering the eyes in the recovery room only reduced the incidence of dreams marginally, it became obvious that the patients who dreamed after ketamine (in all 3 groups) were those who normally dreamed at home. There were 82 patients who were recorded as not being home-dreamers, and only two of these dreamed after ketamine. In contrast, of the 68 home-dreamers, 50 dreamed after ketamine, and 17 of these had unpleasant dreams. In the home-dreamers, covering the eyes reduced the incidence of dreams from 86 per cent in Group 1 to 72 per cent in Group 2 and 64 per cent in Group 3. It is suggested that goggles may be advantageous when dealing with home-dreamers, and a question about the patient's tendency to dream should be included in the preoperative questioning. Alterations in premedication and the use of a quiet dark room during recovery may even further reduce unpleasant dreams in this group.
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PMID:A consideration of ketamine dreams. 110 98

A study of 405 patients revealed that the substitution of 0.1% trichloroethylene for 0.1% methoxyflurane in a previously established technique of anaesthesia led to no remarkable changes in the incidence of postoperative nausea, vomiting or headache. There was, however, an increase in the incidence of awareness from 3.5% to 5.1%. There was no significant difference in the Apgar scores (totals or individual components) or in the materno-foetal acid-base gradients at delivery between the Group A elective Caesarean section patients in the two series. In view of these findings, and of the relative freedom from toxicity and the inexpensiveness of trichloroethylene, a more general re-introduction of the drug into anaesthetic practice is advocated. The study also served to demonstrate that, using the technique described, the duration of the interval from induction of anaesthesia to the initial incision into the myometrium was, at least up to 30 min, of no significant import to the well-being of the infant, but that the time elapsing between uterine incision and complete delivery was directly and significantly associated with neonatal asphyxia and clinically-apparent depression of the infant.
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PMID:A return to trichloroethylene for obstetric anaesthesia. 113 59

The management of a patient is described who has a blood patch for spinal headache, but who had a recurrence of symptoms 1 day later which was successfully treated by a second patch. A second case is described in which there was a second dural puncture immediately prior to the blood patch and, immediately following the blood patch, the patient complained of severe debilitating 'paralysing' pain in both legs. This pain was of short duration and the blood patch was successful. Some further observations on the use of a blood patch are recorded.
Anaesthesia 1975 Nov
PMID:Blood patch for spinal headache. A recurrence and a complication. 121 91

In a 31-year old woman with a six year history of headache and hypertension a diagnosis of primary aldosteronism was made on the basis of urine samples containing 45 mug/day of aldosterone. The preoperative systemic blood pressure was 240 mm Hg systolic and 120 mm Hg diastolic. The serum potassium level was 2.6 mEq/L and other laboratory findings were within normal limits. The patient was to undergo operation. Pre-medication consisted of oral pentobarbitone, intramuscular pethidine and atropine. For induction of anaesthesia, enflurane 2.0-2.5% maximum was given with O2 (21/min) and N2O (61/min); no intravenous agents were used. Suxamethonium chloride 40 mg was administered to facilitate endotracheal intubation. Anaesthesia was maintained with enflurane 1.5-2.0% with 50% N2O and O2. Tubocurarine 27 mg was given for muscle relaxation. When the tumour was manipulated, systemic arterial blood pressure was elevated again to 190 mm Hg systolic and 120 mm Hg diastolic. After removal of the tumour, the arterial pressure and heart rate were stable and recovery from anaesthesia was without circulatory or respiratory complications. Plasma aldosterone levels reached a maximum when the tumour was manipulated and fell to normal levels on the second post-operative day. Cortisol levels were not altered markedly even when the tumour was handled. These data imply that adrenocortical response to enflurane anaesthesia as jadged by plasma aldosterone levels would be different from that as estimated by plasma cortisol levels.
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PMID:Enflurane anaesthesia for removal of aldosterone producing adenoma. 126 18

Spinal anaesthesia, is nowadays one of the safest anaesthetic techniques with low complication rates. Postspinal headache is a complication of spinal anaesthesia. This paper presents several factors associated with the development of postspinal headache and discusses the reduction, prediction and treatment of postspinal headache.
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PMID:[Postspinal headache as an anesthesiology problem]. 134 46

An 82-year-old woman without previous medical problem noticed vague back pain on December 31, 1989, and was admitted to a hospital because she developed a fever, a rapidly progressive weakness followed by anesthesia of the lower extremities and sphincter disturbance. On myelography and myelo-CT, the spinal cord appeared to be displaced by an extramedullary mass which partially blocked the subdural space at the level of T-9 to L-1. When transferred to our hospital on January 8, 1990, she was febrile and complaining of headache with meningeal signs. Percussion tenderness was present at T-8 to L-1 spinal spinous process. Neurological examination revealed that the patient had mild consciousness clouding, total paraplegia in the legs, sensory disturbance of a partial degree at L-1 to L-3 and totally below L-3, brisk but equal tendon reflexes in the upper extremities, areflexia in the legs with positive bilateral Babinski signs and sphincter disturbance. Otherwise she was neurologically unremarkable. Acute inflammatory reactions were prominent among the laboratory findings on admission. A lumbar tap yielded purulent fluid with more than 170,000 cells/mm3, 5,000 mg/dl of protein, 44 mg/dl of glucose and culture of the fluid isolated Escherichia coli. T1-weighted sagittal MRI disclosed an ill defined mass which showed the same or locally higher with gadopentetate dimeglumine (Gd-DTPA) signal intensity as soft tissue, compressing the spinal cord anteriorly from T-7 to L-3. The lesion was noticed to have a more extensive rostral-caudal extent than was inferred from myelography and myelo-CT.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of spinal subdural abscess in the aged--comparative study with neuroradiological findings]. 135 3

The effect of three times daily oral ondansetron in preventing postoperative nausea and vomiting was investigated in two randomized, double-blind, placebo-controlled, multi-centre studies. The first study compared ondansetron 1, 8 and 16 mg to placebo, and the second study compared 8 mg ondansetron to placebo. Both studies included ASA Class I-III female patients about to undergo major abdominal gynaecological surgery or vaginal hysterectomy. In the first study, the 8 and 16 mg ondansetron groups had a significantly lower incidence of nausea and vomiting in the 0-24 h period following recovery from anaesthesia than the placebo group. Ondansetron 8 mg three times daily was also significantly better than placebo in the second study. Side-effects mainly consisted of constipation, headache, and asymptomatic elevation of liver enzymes. The incidence of side-effects was similar in ondansetron- and placebo-treated patients. There appeared to be no clinically important benefit of the 16 mg three times daily ondansetron regimen over the 8 mg three times daily dose, therefore 8 mg three times daily is recommended as the optimal oral dose in the prevention of postoperative nausea and vomiting.
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PMID:Oral ondansetron in the prevention of postoperative nausea and vomiting. 135 7

We report a case of AFP producing gastric cancer manifested by metastasis to the tentorium cerebelli. A 66-year-old male patient was admitted with dysarthria, occipital headache and nausea on May 1, 1990. Neurological examination revealed signs of increased intracranial pressure and the right-sided cerebellar hemispheric signs. CT and MRI showed a round tumor shadow 3cm in diameter, which originated in the right-side tentorium cerebelli and grew in the posterior fossa. Tumor stains fed by the right tentorial artery were recognized by angiography. Serum AFP level was 503.5ng/ml. The patient underwent an operation under general anesthesia in the prone position. The tumor was totally removed via the suboccipital transtentorial approach. Histological examination revealed AFP producing adenocarcinoma. The patient was found to have a gastric cancer after neurosurgical operation, and underwent subtotal gastrectomy by surgeons. Serum AFP level was 254.5ng/ml after removal of metastatic brain tumor, and 5.0ng/ml after subtotal gastrectomy.
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PMID:[AFP producing gastric cancer manifested by metastasis to the tentorium cerebelli; case report and review of the literature]. 137 52

Spinal anaesthesia was performed on 101 patients with a 25-Gauge (0.52 mm) needle. We found a 13.9% overall incidence of postdural puncture headache (PDPH) in an orthopaedic population whose mean age was 33.6 years. This incidence is too high and an alternative technique may be needed.
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PMID:Incidence of postdural puncture headache. A prospective study of 101 spinal anaesthetics in orthopaedic patients. 138 44

A total of 56 women 18-45 years of age weighing 40-100 kg schedules for elective laparoscopic sterilization with or without uterine curettage were randomized into 2 groups, and 25 were subsequently analyzed in each data set. They received either 2 suppositories of 100 mg indomethacin each (Indocid) (Group 1), or 2 identical placebo suppositories (Group 2). At the same time, all patients received a premedication of temazepam 10 mg orally 2 hours preoperatively. General anaesthesia consisted of droperidol 1.25 mg IV, fentanyl 1.5 mcg/kg IV. Filshie clips were used exclusively. Analgesia consisted of 25 mg aliquots of pethidine iv in the recovery room and on the ward by using 1.0 mg.kg of in pethidine, 2-hourly if requested. There was no difference between groups with respect to patient characteristics. In the recovery room, the rating of no pain was lower with 28% in the indomethacin group (group 1) versus 18% in group 2, but the difference was not significant (p = .29). At 30 minutes postoperatively, 54% of those receiving indomethacin compared to 47% of the placebo groups had a pain score less than 30 (p = .09); and 96% compared to 72% had a score less than 70 (p = .07), but these differences were not significant. 48% in group 1 and 32% in group 2 did not require any postoperative pethidine (p = .39). The mean dosage of pethidine used was 24 mg +or- 27 mg in the indomethacin group and 42 mg +or- 44 mg in the placebo group. The Wilcoxon Rank Sum test also showed a nonsignificant trend for lower pethidine dose requirements in the indomethacin group, and in the Log Rank test this difference almost reached statistical significance. The incidence of preoperative (postmedication) nausea, headache and abdominal pain did not differ between the groups. There was a consistently lower incidence of postoperative symptoms or side-effects in the indomethacin group, but this was not statistically significant.
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PMID:Preoperative rectal indomethacin for analgesia after laparoscopic sterilisation. 138 3


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