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

Total intravenous anaesthesia with propofol and alfentanil is an established alternative to inhalation anaesthesia for intracranial neurosurgical procedures. Its usefulness has been somewhat overshadowed by reports of seizure-like movements, both during anaesthesia and in the recovery period. These can be related to the use of either anaesthetic agent, but true epileptogenic properties still remain to be demonstrated in man. Opioid-induced rigidity is a well known phenomenon and must not be mistaken for an epileptic seizure. Myoclonic motor activity can be observed even under physiological conditions, e.g. sleep. Almost all anaesthetic agents have been found to produce "epileptic" EEG changes (spikes, polyspikes, spike-wave complexes), but in man these have never been correlated to motor reactions. Propofol's pro- or anticonvulsive action is unclear. While some groups found shortened convulsing times in patients undergoing electroconvulsive therapy with propofol instead of methohexitone, others have reported activation of epileptogenic foci in the EEGs of known epileptic patients. A synergistic effect of propofol and alfentanil in the generation of seizure-like movements cannot be excluded. Whether seizure-like movements indicate a true "epileptogenic potency" of the anaesthetic drugs or are related to other phenomena remains to be studied. Electro-encephalographic monitoring during anaesthesia as well as careful observation and documentation of motor reactions may contribute to elucidation of the problem. We report a case of seizure-like movements during propofol-alfentanil anaesthesia for an elective craniotomy. A 52-year-old patient presented with a history of headaches of increasing frequency. A CT brain scan demonstrated a tumor in the left occipital region.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A myoclonic seizure during propofol-alfentanil anesthesia?]. 149 34

Propofol or methohexitone was given to the same twenty patients on two separate occasions during total intravenous anaesthesia for microlaryngeal surgery. With propofol the quality of induction was superior. Fewer patients required supplementation. Heart rate and blood pressure were well controlled at levels of 110-120% baseline. There were fewer side-effects during maintenance and recovery. Patients were able to return home earlier. However, apnoea and pain on injection occurred frequently, the latter when injection was made into the dorsum of the hand. With methohexitone, apnoea, abnormal movement, nausea, vomiting, headache, restlessness and confusion were common. Cardiovascular variables were poorly maintained at levels of 170-180% baseline. The results suggest that propofol is suitable as the sole anaesthetic agent in patients undergoing microlaryngeal surgery.
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PMID:Comparative evaluation of propofol or methohexitone as the sole anaesthetic agent for microlaryngeal surgery. 201 95

The effect of propofol, in the emulsion formulation, on post-anaesthetic recovery was studied in 80 patients anaesthetized using one of three different techniques. Propofol was administered to 20 day case patients for induction of anaesthesia, to 20 patients for induction and maintenance by intermittent bolus injection to supplement spinal blockade, and to 40 patients for induction and maintenance by continuous infusion with spontaneous ventilation. Its effects were compared with those of methohexitone (all three techniques) and thiopentone (day case study only). The assessment of post-operative recovery included measurement of the speed of immediate recovery, psychometric testing comprising choice reaction time and critical flicker fusion threshold and the incidence of post-operative sequelae. In all three techniques, propofol was associated with rapid and symptom-free recovery from anaesthesia. With the day case and infusion techniques immediate recovery was more rapid after propofol than after methohexitone and thiopentone. Recovery of psychomotor function was more rapid after propofol in the day case study. The frequency of sequelae such as nausea and vomiting (5% of cases), headache (1%) and confusion/restlessness (2.5%) was considerably lower overall after propofol and in each individual study than with the other agents.
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PMID:Recovery following propofol ('Diprivan') anaesthesia--a review of three different anaesthetic techniques. 387 81

Objective To evaluate the efficacy and safety of the combination treatment of ECT and venlafaxine among treatment-resistant depressive patients. Methods We reviewed 21 depressive patients who were treated with a combination of electroconvulsive therapy (ECT) and venlafaxine. The indication of the ECT-venlafaxine treatment was inadequate response to at least one antidepressant trial of adequate doses and duration. Propofol was used as an anesthetic agent during ECT treatments. Results Ninety percent of the patients benefited from the combined treatment. The responsivity to the combination treatment was not associated with high dose of venlafaxine. In most of the patients, the combined treatment was safe and well tolerated. Adverse reactions occurred in 57% of the patients and included concentration difficulties (four patients), memory problems (seven patients) and headache (one patient). No asystole was observed. Treatment was safe with a low dose of venlafaxine equal to or lower than 225 mg/day. Conclusions It seems that treatment of ECT combined with low dose venlafaxine and propofol as anesthetic agent is effective and safe. This strategy may be a therapeutic option in treatment-resistant depressive patients.
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PMID:The combined treatment of venlafaxine and ECT in treatment-resistant depressive patients. 2494 39