Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of long-term (> or = 3 months) neuropathy in 350 melanoma patients treated with single normothermic or 'mild' hyperthermic perfusion with melphalan in the period 1978 to 1990 was studied. Long-term neuropathy was encountered in 14 patients; in 10/51 patients (20%) after perfusion at the axillary level and in 4/247 patients (2%) after perfusion at the iliac level. After brachial and femoro-popliteal perfusions no long-term neuropathy was observed. Neuropathy, mainly consisting of paresis/paralysis of the hand and/or fingers, anaesthesia, and/or paraesthesiae, improved over a mean period of 16 (3-43) months in eight patients, but three patients still had serious neuropathy one year after perfusion. In another six patients little improvement was seen and four died with permanent neuropathy. Acute regional toxicity after perfusion and the application of 'mild' hyperthermia did not seem to influence the incidence of long-term neuropathy. This complication is probably a result of the isolating Esmarch rubber bandage being applied too tightly during perfusion at a proximal level. At the axillary level, where the brachial plexus lacks the protection from enveloping tissues, nerve damage is especially prone to occur. We recommend applying this bandage no tighter than is necessary to maintain the isolation of the circuit. This implies meticulous surgical isolation of the vascular system and accurate monitoring of leakage.
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PMID:Long-term neuropathy after regional isolated perfusion with melphalan for melanoma of the limbs. 799 21

Eye-opening and eye movements were assessed in 110 awake and cooperative ASA class 1 and 2 patients after elective ENT surgery with total intravenous anaesthesia using propofol, fentanyl and atracurium. Following tracheal extubation and after regaining consciousness 21 patients showed a complete transient bilateral inability to open their eyes combined with a total gaze paresis, while another 30 patients showed an impairment of eye-opening and/or eye movements to a lesser extent. In all patients affected symmetrical recovery of both impaired eye-opening and eye movements occurred during the following 20 min. The occurrence of ophthalmological symptoms was not related to the duration of anaesthesia or the propofol infusion rate. Thus a complex ophthalmological phenomenon occurred after total intravenous anaesthesia in approximately 50% of awake and cooperative patients. The aetiology of this phenomenon and the implications for the understanding of the mechanisms of general anaesthesia remain to be determined.
Anaesthesia 1994 Jun
PMID:External ophthalmoplegia after total intravenous anaesthesia. 801 99

It has been reported that subcutaneous administration of pancuronium produces prolonged neuromuscular blockade. The purpose of this study was to evaluate the antagonistic effect of neostigmine on neuromuscular blockade following subcutaneous injection of pancuronium in anesthetized patients. Fourteen male patients aged 32-67 yr, weighing 50-58 kg, and scheduled for surgical operation lasting more than 6 hr were included in the study. None of the patients had paresis. Anesthesia was induced with thiamylal and SCC. Patients under N2O-oxygen-enflurane (1.0-1.5%) anesthesia, were divided into two groups (n = 7 in each group). Group A was given an intravenous bolus of pancuronium 6 mg. Group B received pancuronium 6 mg subcutaneously in the ankle. Train-of-four responses were evaluated every 12s by measuring the force of thumb adduction produced in response to supramaximal stimulation of the ulnar nerve at the wrist. When the train-of-four ratios recovered to approximately 0.2 in groups A and B, a mixture of neostigmine 1.0 mg and atropine 0.5 mg was administered. The onset of fade in train-of-four responses was significantly more rapid in group A (intravenous administration) than in group B (subcutaneous administration). Time intervals to maximum train-of-four depression from pancuronium administration in groups A and B averaged 2.6 and 125.4 min, respectively. No significant differences in the recovery times of the train-of-four ratios from 0.2 to 0.7 following neostigmine administration in groups A and B were demonstrated. None of the patients who received pancuronium subcutaneously showed recurarization following neostigmine administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Antagonism to neuromuscular effect of subcutaneous administration of pancuronium by neostigmine]. 807 47

Nine patients had a permanent paresis of a vertical rectus muscle after cataract extraction. We sought to determine the common factors associated with and their contribution to vertical muscle paresis after cataract extraction. The study design included a survey that was conducted among the referring cataract surgeons and anesthesiologists with particular attention to surgical technique and anesthetic administered, as well as a medical history and examination and appropriate laboratory tests. Patients had a complete ophthalmic examination including prism cover testing in all nine diagnostic positions, forced-duction testing, and saccadic velocity and generated muscle force estimation. The results of the study demonstrate no correlation between the pareses and the use of a bridle suture, antibiotic or corticosteroid injection, systemic disease, or surgical technique. Peribulbar anesthesia was the most consistent feature in seven of the nine cases. In the other two, an atypical retrobulbar injection had been given. On the basis of the location of the injections, the needle type, and the concentration and quantity of the anesthetic injected, we conclude that permanent pareses of a vertical rectus muscle may be caused by a myotoxic effect of the local anesthetic.
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PMID:Paresis of a vertical rectus muscle after cataract extraction. 821 71

The work is based on the analysis of treatment of 212 children with generalized purulent peritonitis of appendicular origin at 7 different pediatric surgical clinics of Russia. The total mortality rate was 1.9%. It is shown that the removal of pus from the abdominal cavity by aspiration has no advantages over its removal by means of moistened tampons. Irrigation of the abdominal cavity during the operation does not affect essentially the results of treatment of patients with generalized purulent peritonitis. Drainage of the abdominal cavity by means of an aspiration drain installed properly and methodically leads to a lesser number of postoperative abdominal abscesses and continuing peritonitis. Administration of antibiotics into the abdominal cavity at the end of the operation and in the postoperative period does not influence significantly a decrease in the incidence of postoperative purulent complications. Peridural anesthesia has no advantages over other methods in the control of intestinal paresis and prevention of adhesive intestinal obstruction.
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PMID:[Evaluation of methods for local treatment of generalized purulent peritonitis of appendicular origin in children]. 826 66

This study was designed to investigate the incidence and clinical consequences of hemidiaphragmatic paresis in patients undergoing carotid endarterectomy using cervical plexus block anesthesia. In 28 patients, diaphragmatic motion was evaluated by fluoroscopy 20 min after cervical plexus block with 1% mepivacaine. In 61% of the patients abnormalities of diaphragmatic motion were detected. These motion anomalies were associated with a statistically significant elevation of PaCO2. Gender, age, and whether the block was on the left or right side did not appear to affect the incidence of motion abnormalities after cervical plexus block anesthesia.
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PMID:Incidence and clinical significance of hemidiaphragmatic paresis in patients undergoing carotid endarterectomy during cervical plexus block anesthesia. 829 60

The porphyrias are a group of disorders of haem metabolism. A knowledge of which anaesthetic can precipitate an acute attack of porphyria is important, since an accumulation of metabolites can result in life threatening symptoms, such as abdominal pain, vomiting, photophobia, neuropathy, bulbar paresis and respiratory failure. Treatment consists primarily of adequate calorie intake e.g. glucose, but is otherwise symptomatic. Anaesthetic drug recommendations are based both on animal experiments and patient experience, primarily case histories. An array of local anaesthetics, hypnotics, sedatives, neuroleptics, analgesics, muscle relaxants, inhalation anaesthetics and some antibiotics are reviewed. Patients with a history of porphyria should be in an optimal condition and maintain a high calorie intake perioperatively. The pre-operative fast should be a minimum and iv-glucose is advisable while fasting. There are anaesthetic agents that are safe for both regional and general anaesthesia.
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PMID:[Anesthesia and porphyria]. 831 98

A 52-year-old woman with chronic back pain presented for lumbar extradural analgesia. The 'loss of resistance to air' technique was used to locate the extradural space. Prolonged paraesthesia and paresis of left leg occurred following the procedure. Urgent lumbar computed tomography scan revealed nerve root displacement due to extradural air.
Anaesthesia 1993 May
PMID:Extradural air as a cause of paraplegia following lumbar analgesia. 828 45

From April 1987 to April 1992, 116 phonosurgical procedures were performed to treat glottal incompetence. The initial numbers of these surgical procedures included the following: 29 primary Silastic medializations, 3 primary Silastic medializations with arytenoid adduction, 53 secondary Silastic medializations, 4 secondary Silastic medializations with arytenoid adduction, and 11 bilateral Silastic medializations. These procedures are useful in treating unilateral true vocal cord paralysis, scarring, bowing, or paresis, as well as bilateral true vocal cord bowing. Of the initial 100 patients, 16 later underwent a revision with either a larger implant's being placed or an arytenoid adduction. Primary Silastic medialization is the placement of an implant under general anesthesia in the same surgical setting in which laryngeal innervation is sacrificed. Secondary Silastic medialization is the placement of an implant under local anesthesia for a preexistent vocal cord malfunction. In either case, overall voice results for unilateral paralysis are very good. Primary Silastic medialization significantly decreases the postoperative rehabilitation period in skull base patients because of the immediate postoperative glottal competence and decreased use of perioperative tracheotomy. Bilateral implants yielded good results in 6 patients with presbylaryngis, but 6 other patients with bowing from other causes experienced only moderate improvement in speech quality. There were no implant extrusions; however, 1 implant was removed secondary to a persistent laryngocutaneous fistula in a patient who had previously undergone laryngeal irradiation. This was the only complication in this series.
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PMID:Silastic medialization and arytenoid adduction: the Vanderbilt experience. A review of 116 phonosurgical procedures. 839 Feb 15

Transcranial magnetic stimulation was used for intraoperative motor evoked potential monitoring during surgery of intramedullar, extramedullar, and extradural spinal tumors in 13 patients. Anesthesia was based on etomidate. Magnetic stimulation for motor evoked potential monitoring was successful in 10 of 13 patients, 12 of whom were neurologically impaired. Motor evoked potentials were recorded from limb muscles or from the fibers of the cauda equina. Amplitudes of baseline recordings (the initial recording obtained after induction of anesthesia) were decreased by 64 +/- 34% (mean +/- SD) and baseline latencies were increased by 7 +/- 8% compared with the preoperative recordings. Subsequent recordings were analyzed for amplitude and latency changes in comparison to baseline. Amplitude changes exceeding 50% and latency changes higher than 3 ms compared with the baseline correctly indicated an impending lesion of motor pathways with increased paresis postoperatively. In cases where motor evoked potential monitoring was successful prediction of short-term postoperative motor outcome was always correct. There were no "false-negatives" or "false-positives."
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PMID:Magnetic stimulation for monitoring of motor pathways in spinal procedures. 848 45


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