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Query: UMLS:C0026827 (hypotonia)
 5,860 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The following report of our experience using isobaric Bupivacaine 0.5% in 6,228 operations (intrathecal technique) will consider the intra operative period. In 55.8% of cases the lower extremities were operated upon and in 44.2% the lower abdomen. In 1,487 cases (23.9%) side effects/complications were evident and a classification of such is as follows: anaesthetic technique 5.29%, cardiorespiratory 15.69%, operator/operative technique 6.13%. The percentage remained relatively constant irrespective of age but a higher pre op risk classification (A.S.A. System) resulted in a marked increase in the above figures. The principal side effects encountered were as follows: Bradycardia 7.5%, hypotonia 6.3%, insufficient analgesia 3.9%, extrasystoles 2.9%. Grave complications occured in 0.15% and within this group 4 patients died intraoperatively; a relationship with the mode of anaesthesia has not been proven.
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PMID:[Spinal anaesthesia using bupivacain--clinical experience of more than 6000 cases (author's transl)]. 49 24

Beta2-sympathomimetics are the most powerful inhibitors of uterine contraction used in order to prevent threatening fetal asphyxia. These drugs, however, can cause harmful interactions with anaesthetics during caesarean section. Our patient-material consists of parturients, who were given a beta2-sympathomimetic, ritodrine, immediately before caesarean section performed under combined general anaesthesia. These patients showed significantly more marked tachycardia, hypotonia and abundant haemorrhage during operation as a consequence of poor uterine contractility than did the control group. Rapid variations in the circulation of the mother may also be disadvantageous to the wellfare of the fetus. These side-effects can best be minimized by omitting atropine-premedication and by expanding the blood volume of the mother before caesarean section with adequate infusion of Ringer-type.
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PMID:[The harmful effects of beta2-sympathomimetic drugs as uterine relaxants on caesarean section (author's transl)]. 69 85

General anesthesia in ophthalmological surgery has become a great fashion. However there are still many problems especially in intraocular surgery. The eye with normal intraocular pressure generally needs no special technique. Most of the usual anesthesia produce a slight hypotonia with the exception of Succinylcholine, whose effect is contrary. Unfortunately this is not the case in eyes with pathologically increased intraocular pressure as in the different forms of glaucoma. Eye surgeons and anesthesists therefore look for solutions to this problem which in principle consist in the application of medicaments, which not seldom are rather agressive. The controlled hypotension by ganglion blockers, the curarisation in the state of being awake, the rapid perfusion of solutions with high osmotique effect (isolated or associated) represent such measures. The one has the disadvantage to be applied during so-called subvigile anesthesias where the security that the patient is asleep is rather doubtful; the other has the disadvantage that it requires a rapid perfusion of solutions with highly osmotic effect. It goes without saying that these conditions represent risks especially if one considers that the candidates for this type of intervention very often are senile persons with prearious cardiovascular equilibrium, with insufficient renal function and with insufficient arterial cerebral circulation. These are some of the problems which are to be discussed.
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PMID:[Anesthesia in ophthalmology (author's transl)]. 85 70

Hypnosis is able to induce a state of total psychological calm in very many subjects, including maintenance or even enhancement of their ability to cooperate. A smaller number of more receptive subjects may even achieve ocular anaesthesia, though this is not suitable for the performance of operations because the Dagnini-Aschner reflex persists and hypotonia is not attained. It is considered, therefore, that the association of hypnosis, retrobulbar pharmacological anaesthesia, and akinesia offers the best conditions for the performance of operations involving major opening of the eyeball, such as those associated with cataract, i.e. psychological tranquility with the ability to cooperate, anaesthesia with neurovegetative areflexia, hypotonia, and a postoperative course undisturbed by coughing and vomiting. The results of several years' experience have shown the complete suitability of the method and its wide possibilities of application.
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PMID:[Hypnosis in ophthalmology]. 118 37

The effect of maprotiline (N-methyl-9, 10-ethanoanthracene-9 (10H)-propylamine) on animal behavior was investigated in mice and rats and compared with those of amitriptyline and imipramine. Maprotiline inhibited reserpine hypothermia in mice and tetrabenazine ptosis in rats, while it potentiated the effects of methamphetamine, L-DOPA and apomorphine in mice, in a similar manner to that of amitriptyline and imipramine. Maprotiline was more potent than anitriptyline and imipramine in antagonizing haloperidol-induced catalepsy as well as in suppressing muricide induced by either olfactory bulbectomy or delta-9-tetrahydrocannabinol in rats. Maprotiline potentiated anesthesia induced by thiopental or ether in mice to a lesser degree than did amitriptyline, and failed to counteract the lethal effect of physostigmine or oxotremorine tremor in mice, indicating that this drug has no central anti-cholinergic effect. Maprotiline markedly inhibited hyperemotionality of the rat with either septal lesions or olfactory bulb ablations, suggesting that it does have a tranquilizing effect. Inhibition of conditioned avoidance response of the rat in the shuttle box and reduction of methamphetamine group toxicity with maprotiline were similar to those with amitriptyline. Maprotiline exaggerated pentetrazol convulsion, decreased muscle tone and impaired coordinated motor activity in mice to a much lesser degree than amitriptyline and imipramine. LD50 of maprotiline was approximately twice that of imipramine and three times that of amitriptyline. These results indicate that maprotiline is a new type of antidepressant, has a low toxicity and shares both potent antidepressant and some tranquilizing effect, without possessing central anticholinergic action.
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PMID:[Behavior pharmacology of maprotiline, a new antidepressant]. 124 Aug 30

General pharmacological properties of cefepime (CFPM), a new injectable semisynthetic cephalosporin and its metabolite N-methylpyrrolidine-N-oxide (NMP-N-oxide) were studied in laboratory animals. The results obtained are summarized as follows: 1. CFPM reduced spontaneous locomotor activity but potentiate the anesthesia at the highest dose in mice. Furthermore, significant hypothermia and analgesia were observed at the same dose in mice. No effects were found on the other CNS function in mice and rats or on EEG activities in rabbits. 2. Muscle relaxant activity was not observed in mice treated with CFPM even at the highest dose. 3. CFPM had no effect on the intestinal smooth muscle and did not show any antagonism against some smooth muscle contracting drugs. 4. The respiration, blood pressure, heart rate and ECG were affected by CFPM. Those changes, however, might have been principally caused by L-arginine blended with CFPM product. 5. No effect of CFPM on the intestinal movement or gastric secretion was found even at the highest dose of CFPM. 6. The pH neutralizer L-arginine caused alterations in the renal function and electrolyte metabolism but CFPM did not. 7. Whole blood clotting time tended to be lengthened by CFPM at the highest concentration but this effect seemed to have been caused by L-arginine. Other parameters of the coagulation system or red blood cell resistance were not affected by CFPM. 8. NMP-N-oxide, a metabolite of CFPM, had almost no effect on any of the tested parameters except for its slight effect on the circulatory system. These findings indicate that CFPM has scarcely any pharmacological properties which might be leading to severe adverse reactions in clinical use.
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PMID:[General pharmacology of cefepime]. 150 98

A case of a woman with Ehlers-Danlos syndrome who was able to carry pregnancy to term with bed rest and a Smith-Hodge pessary is described. The 22-year old black woman, who had been diagnosed with Ehlers-Danlos syndrome at age 10, was referred at 14 weeks' gestation. Her diagnosis was based on history of hypotonia in infancy, easy bruising, hypermobile joints, kyphoscoliosis, hyperelastic skin, and microcorneas. She had marked kyphoscoliosis, severe varicose veins, a long closed cervix, and severe restrictive lung disease. She was diagnosed with cervical incompetence based on a previous miscarriage. A skin biopsy was performed and severe type IV Ehlers-Danlos disease was ruled out. It was decided not to do cervical cerclage because of the risk of tears. Instead the patient was treated with bed rest at home, and a Smith-Hodge pessary, which she removed and washed twice daily. At 29 weeks' gestation, the cervix was dilated 1 cm, the fetus was ballottable in vertex, and there were no contractions. The woman was hospitalized for bed rest, given 12 mg betamethasone im every 24 hours for 2 days, then 12 mg weekly. At 33 weeks' gestation the cervix had dilated to 5 cm, the membranes had ruptured, and contractions began. She was delivered of a 1470 gm male over a small midline episiotomy. The total time in labor was 4 hours. Blood loss was 250 cc. The episiotomy scar healed well. Both epidural and general anesthesia would have been contraindicated in this patient because of her vertebral deformities and her lung disease. The infant had Apgar scores of 7 and 9 and 1 and 5 minutes, and was normal.
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PMID:Successful treatment with the Smith-Hodge pessary of cervical incompetence due to defective connective tissue in Ehlers-Danlos syndrome. 155 Jun 28

A 71-year-old male patient was operated on in a septic state (tachycardia, hypotonia, fever peaks, disorientation) because of an occluding tumour of the biliary tract. Ketamine was used as the main anaesthetic. Mean arterial pressure increased markedly and diuresis started during the anaesthesia. The inotropic support (dopamine, dobutamine, noradrenaline) could be reduced. Ketamine anaesthesia seemed to have a beneficial haemodynamic effect in septic shock.
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PMID:Ketamine anaesthesia in a patient with septic shock. 163 73

Forty-seven healthy parturients undergoing elective Caesarean section were randomly allocated to either general anaesthesia (n = 24) or epidural anaesthesia (n = 23) under standardized anaesthetic and surgical conditions. Seven women of the epidural group required additional systemic analgesia or sedation following delivery of the neonate. Nine of 24 newborns obtained 1-min Apgar scores below 7 after general anaesthesia compared to only 3/23 after epidural anaesthesia. The time period to establish normal colour in the babies was 2.2 min after epidural and 4.9 min after general anaesthesia. Three of the 24 general-anaesthesia newborns demonstrated a tendency to hypotonia compared to only one in the epidural group. Twenty-four hours and 7 days after delivery all infants of both groups were completely normal. At the time of delivery maternal PO2 was higher in the general anaesthesia compared to the epidural group, due to higher inspired oxygen concentrations. Comparable results were obtained in umbilical PO2 venous values; lower pH values, however, were observed in the umbilical artery after general anaesthesia. There were no significant differences in the glucose levels between the groups. A significant correlation was established between uterine incision-delivery interval and 1-min neonatal Apgar scores in the general-anaesthesia group, but not in the epidural group. Our investigation did not show either the incision-delivery interval or the start of operation-delivery interval to play a role in neonatal outcome. Epidural anaesthesia is superior to general anaesthesia in Caesarean section under normal conditions with regard to neonatal outcome. Whether this is also true for critical conditions cannot be concluded from this study.
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PMID:General anaesthesia versus epidural anaesthesia for primary caesarean section--a comparative study. 173 94

Audiological tests were conducted on 34 patients before and after undergoing an operation under spinal anesthesia. One of these patients developed a considerable unilateral hearing loss in the low-frequency range, which persisted until an epidural blood-patch was given. Unexpectedly, we also found a general small significant threshold shift at 500 Hz, which has never before been described in the literature. The biological mechanism is discussed and the results suggest that the explanation of the hearing loss could be an endolymphatic hydrops resulting from perilymphatic hypotonia due to loss of liquor, during and after the spinal anesthesia.
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PMID:Low-frequency hearing loss after spinal anesthesia. Perilymphatic hypotonia? 184 92


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