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Query: UMLS:C0027066 (myoclonus)
 4,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Canine distemper myoclonus was electromyographically analysed to throw more light upon the condition without invasive surgical intervention. Although myoclonus seemed to occur synchronously in many muscles, the onset of myoclonus appeared to be slightly earlier in one or two particular muscles and, furthermore, myoclonus did not arise temporally in descending or ascending order along the neuroaxis. Myoclonus-like discharges were evoked by tendon-tapping and this feature disappeared after cessation of myoclonus. In successive myoclonic bursts, a significant positive correlation was noted between the silent period and the subsequent discharge period, independently of the level of consciousness, i.e., the longer the silent period, the longer the subsequent episode of myoclonus. This correlation was re-established very early after recovery from anesthesia with halothane, when electroencephalograms showed slow waves. These results strongly indicate that the lower motor neurons may be the primary site responsible for the genesis of canine distemper myoclonus.
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PMID:Electromyographic analysis of canine distemper myoclonus. 268 52

Intravenous administration of etomidate, a nonbarbiturate sedative hypnotic, induced excitement, myoclonus, pain on injection, vomiting, and apnea during induction of anesthesia in 20 experimental dogs and 70 hospitalized dogs. The dogs had excitement and purposeless muscle movements during recovery from anesthesia. The frequency and severity of the side effects were markedly attenuated or eliminated by the administration of diazepam, acepromazine, or morphine prior to etomidate administration.
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PMID:Side effects of etomidate in dogs. 272 35

One hundred and eighty female patients received either propofol 2.5 mg/kg or etomidate 0.3 mg/kg injected over 20, 40 or 80 seconds for induction of anaesthesia after premedication with temazepam 20 mg. The mean induction times for both etomidate and propofol were significantly reduced with increasing speed of injection. The mean induction times for etomidate were significantly less than propofol at the slower rates of injection. At each speed of injection, the decrease in systolic, mean and diastolic arterial blood pressures with etomidate were less than with propofol. The decrease in systolic blood pressure was not significantly affected by injection speed for either drug. Apnoea occurred significantly more frequently with propofol than with etomidate at each speed of injection and the incidence of apnoea greater than 60 seconds with propofol was significantly higher when injected over 20 seconds than 80 seconds. The incidence of pain on injection was unaffected by injection speed for either drug. The incidence of myoclonus and (or) hypertonus was significantly higher following etomidate.
Anaesthesia 1989 May
PMID:The effects of speed of injection on induction with propofol. A comparison with etomidate. 278 27

This is a report about five anaesthetic techniques for laparoscopy. Propofol and etomidate were used for total intravenous anaesthesia. Propofol, etomidate and thiopentone were used as induction agents prior to inhalational anaesthesia with isoflurane and nitrous oxide. Fentanyl was used for analgesia. Induction with propofol and thiopentone was rapid. Etomidate induction was characterised by myoclonus. Maintenance was smooth with inhalational anaesthesia. Of the groups that received total intravenous anaesthesia, propofol provided stable anaesthesia but required extra bolus doses. Recovery was the most rapid following total intravenous anaesthesia with propofol. Postoperative side effects were much lower after propofol. No difference was observed between the groups with regard to changes in arterial blood pressure and heart rate.
Anaesthesia 1987 Aug
PMID:Anaesthesia for laparoscopy. A comparison of five techniques including propofol, etomidate, thiopentone and isoflurane. 295 68

Early observations, made between 1935 and 1947, on the EEG discharges associated with myoclonic jerking are reviewed, together with the contemporary findings on the stimulus-sensitive myoclonus produced in cats under chloralose anesthesia. The accumulating evidence on the relative roles of cortex, brainstem, and cerebellum in producing this type of myoclonus is briefly summarized. The significance of large SEPs and their presence and absence in various clinical types of myoclonus is considered. Three distinctions are drawn with regard to the clinical features of myoclonic jerking: between action myoclonus and myoclonus at rest; between focal and generalized jerking; and between the lightning-like, irregular, stimulus-sensitive jerks of myoclonic epilepsy and the rhythmical, stimulus-insensitive jerking of segmental myoclonus. Some findings bearing on the possible mechanisms of the abnormal discharges responsible at cell membrane level are mentioned.
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PMID:Evolving ideas on the neurophysiology of myoclonus. 308 Aug 52

Thirty-nine unpremedicated patients who presented for cystoscopy were given either alfentanil or saline in a random double-blind fashion immediately before anaesthesia with etomidate, nitrous oxide and enflurane. Alfentanil significantly reduced myoclonus associated with etomidate. During anaesthesia, patients who received alfentanil had smaller minute volumes, lower respiratory frequencies, and smaller increases in heart rate. The incidence of apnoea was not significantly increased. After operation, patients who received alfentanil were prescribed significantly more analgesia, possibly because of their reduced uptake of volatile anaesthetic agent. It is concluded that supplementation with alfentanil improves the quality of anaesthesia induced with etomidate.
Anaesthesia 1986 May
PMID:Alfentanil supplemented anaesthesia for short procedures. A double-blind study of alfentanil used with etomidate and enflurane for day cases. 308 48

Haemodynamic changes and side-effects of induction of anaesthesia with etomidate were evaluated in 60 ASA Class I or II patients. The objective was to find an optimal pre-induction dose of fentanyl which eliminated haemodynamic changes and side-effects during induction and intubation without introducing other problems. Patients were randomly assigned to four groups according to the pretreatment dose of fentanyl (Group I = 2 ml normal saline; Group II = 100 micrograms of fentanyl; Group III = 250 micrograms of fentanyl; Group IV = 500 micrograms of fentanyl) administered intravenously five minutes prior to induction of anaesthesia with etomidate, 0.3 mg/kg. There was an increasing incidence of apnoea (53, 87, 87 and 100% in Groups I-IV respectively) and a decreasing incidence of myoclonus (60, 33, 13 and 0% in Groups I-IV respectively) and injection pain (53, 13, 7 and 0% in Groups I-IV respectively), P less than 0.002 chi-square test for linear trends, with increasing fentanyl dosage. The incidences of postoperative nausea and vomiting were similar in the four groups. There were also significant linear regression relationships (P less than 0.01 ANOVA for linear regression) between increasing doses of fentanyl administered before etomidate and the prevention of increases in systolic blood pressure and heart rate during the induction-intubation sequence. The data demonstrate that increasing pre-induction doses of fentanyl are more effective at minimising side-effects and preventing increases in systolic arterial blood pressure and heart rate but also increase the incidence of apnoea during induction. The results suggest that 500 micrograms of fentanyl is an ideal pretreatment dose in fit patients prior to anaesthetic induction with etomidate.
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PMID:Fentanyl pretreatment modifies anaesthetic induction with etomidate. 339 9

Hemodynamic changes and side effects of anesthesia induction with etomidate or thiopental were evaluated in 83 ASA class I or II patients. Patients were randomly assigned to one of 12 groups according to pretreatment drug (fentanyl, 100 micrograms, or normal saline intravenously), induction agent (etomidate, 0.4 mg/kg, or thiopental, 4 mg/kg), and maintenance anesthetic technique (isoflurane-oxygen, isoflurane-nitrous oxide-oxygen, or fentanyl-nitrous oxide-oxygen). The purpose of this experiment, of factorial design, was to evaluate the combined effects of two or more experimental variables used simultaneously and to observe interaction effects. There were significant increases in heart rate in all groups, especially after tracheal intubation. These increases were attenuated but not eliminated by fentanyl pretreatment. Systolic arterial blood pressure increased significantly after intubation and was not affected either by fentanyl pretreatment or by the induction agent. Patients in whom anesthesia was induced with etomidate had a greater incidence of pain on injection and myoclonus and a lesser incidence of apnea than patients in whom anesthesia was induced with thiopental. Fentanyl pretreatment significantly decreased the incidence of pain on injection and myoclonus, but it increased the incidence of apnea when anesthesia was induced with etomidate. The incidence of postoperative nausea and vomiting was similar after thiopental and etomidate and was unaffected by fentanyl pretreatment. (ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Etomidate versus thiopental for induction of anesthesia. 402 53

Etomidate has been studied in two groups of patients. In Group 1, 50 patients received etomidate 100 micrograms/kg/minute with fentanyl and a muscle relaxant, ventilation being with air and oxygen (50%). The technique gave a smooth, pleasant induction with all patients asleep within 2 minutes. The incidence of pain on infusion was 6% and of myoclonus 6%. Cardiovascular changes were minimal, the most common finding being persistent tachycardia. The mean recovery time was 9.1 minutes. There was no incidence of awareness, recall, or thrombophlebitis, but a 20% incidence of nausea and vomiting. In Group 2, 20 patients received the same dosage of etomidate to supplement spinal anaesthesia for lower abdominal surgery. The technique worked most satisfactorily, with patients falling quietly to sleep within 2-3 minutes with no hiccoughs, coughing or laryngospasm. Six patients exhibited myoclonus, one being severe. In no case did myoclonus interfere with the operation. The cardiovascular system remained stable in all patients. Mean recovery time was 16.1 minutes (range 3-38 minutes). Twitching and restlessness were the main complications during recovery.
Anaesthesia 1983 Jul
PMID:Etomidate infusion. Its use in anaesthesia for general surgery. 686 59

The purpose of this report is to describe a new complication of propofol administration. A previously fit patient underwent intravenous anaesthesia with propofol for removal of dental wires. Postoperatively he developed myoclonic jerking of his limbs. On regaining consciousness he complained of an occipital headache, neck stiffness and photophobia, and was found to have nuchal rigidity on examination. These clinical features resolved over the following week. Subsequent investigations failed to explain the aetiology of the symptoms of meningeal irritation, which suggests that propofol was the causative agent. While prolonged myoclonus has been previously described with propofol administration, this is the first report of meningism occurring with its use.
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PMID:Prolonged myoclonus and meningism following propofol. 872 64


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