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)

Cordotomy should be reserved for patients with intractable pain resistant to conservative treatment that is not of a dysaesthetic type. The high cervical percutaneous technique permits exploitation of the principles of stereotactic surgery, especially physiological localization of the lesion site. The induction by 100 Hz stimulation of a warm or cool tingling in some portion of the contralateral half of the body without muscle tetanization ensures location within the spinothalamic tract while attention to the somatotopographic organization of the responses permits a certain degree of tailoring of the extent of analgesia to the patient's needs. During 264 consecutive procedures the spinothalamic tract was successfully located in 99% with a 0.3% incidence of significant persistent paresis.
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PMID:Percutaneous cervical cordotomy. 14 48

The present study has utilized a clinical model to compare the pharmacokinetics of four currently available amide local anaesthetic agents in theoretically equipotent concentrations. In addition to providing comparative data concerning the onset and duration of analgesia, anaesthesia, paresis, and paralysis, it has provided definitive confirmation of the clinical impression that under certain circumstances following the performance of a nerve block, motor blockade may actually precede sensory blockade, and an explanation for this seeming violation of established neurophysiological principles has been postulated. The study has also raised questions concerning the sequence of recovery from motor and sensory blockade which still await explanation.
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PMID:Clinical pharmacokinetics of local anaesthetics. 84 77

Several authors have questioned the potential for phrenic nerve paralysis with interpleural analgesia. This study was designed to examine the potential for phrenic nerve paralysis with the use of interpleural bupivacaine in dogs. Seven dogs were anesthetized, tracheally intubated, and allowed to breathe spontaneously with halothane/oxygen while in the supine position. After a midline laparotomy, two wires were inserted into the costal portion of each hemidiaphragm for measurement of electromyographic (EMG) signals. A balloon catheter was placed in the abdominal cavity to measure abdominal pressure. The abdomen was then closed. Airway pressure was measured through a side port in the endotracheal tube. Bilateral interpleural catheters were inserted with the loss-of-resistance technique. Each dog was used for two experiments, one on each side, except for one animal. To assess the contribution of the ipsilateral diaphragm to total respiratory effort, the airway was occluded at functional residual capacity for three consecutive breaths, and EMG, airway pressure, and abdominal pressure were measured. In five of nine experiments with bupivacaine, there was complete loss of EMG activity on the side of the injection. In two dogs, there was partial loss of diaphragmatic function, and in the remaining two, there was no change in EMG. In the normal saline solution group (n = 4), there was no change in the EMG. Two dogs that received bilateral bupivacaine injections developed paradoxical respiration with negative inspiratory intraabdominal pressures. Phrenic nerve paralysis or paresis can occur with interpleural blockade. The factors affecting the occurrence of this complication remain to be elucidated.
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PMID:Effects of interpleural bupivacaine (0.5%) on canine diaphragmatic function. 132 26

The present study compares the effectiveness of 0.25% ropivacaine and 0.25% bupivacaine in 44 patients receiving a subclavian perivascular brachial plexus block for upper extremity surgery. The patients were assigned to two equal groups in this randomized, double-blind study; one group received ropivacaine 0.25% (112.5 mg) and the other, bupivacaine 0.25% (112.5 mg), both without epinephrine. Onset times for analgesia and anesthesia in each of the C-5 through T-1 brachial plexus dermatomes did not differ significantly between the two groups. The mean onset time for analgesia ranged from 11.2 to 20.2 min, and the mean onset time for anesthesia ranged from 23.3 to 48.2 min. The onset of motor block differed only with respect to paresis in the hand, with bupivacaine demonstrating a shorter onset time than ropivacaine. The duration of sensory and motor block also was not significantly different between the two groups. The mean duration of analgesia ranged from 9.2 to 13.0 h, and the mean duration of anesthesia ranged from 5.0 to 10.2 h. Both groups required supplementation with peripheral nerve blocks or general anesthesia in a large number of cases, with 9 of the 22 patients in the bupivacaine group and 8 of the 22 patients in the ropivacaine group requiring supplementation to allow surgery to begin. In view of the frequent need for supplementation noted with both 0.25% ropivacaine and 0.25% bupivacaine, we do not recommend using the 0.25% concentrations of these local anesthetics to provide brachial plexus block.
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PMID:A comparative study of 0.25% ropivacaine and 0.25% bupivacaine for brachial plexus block. 153 Jan 73

We examined the onset and distribution of sensory blockade, the onset of motor blockade, and venous mepivacaine concentrations after axillary block with 1.25% mepivacaine with and without bicarbonate. There were no statistically significant differences between the alkalinized and placebo groups with respect to distribution of analgesia or anesthesia, time to onset of analgesia, or time to onset of paresis. However, alkalinization significantly decreased the time to onset of anesthesia in the medial cutaneous nerve of the forearm, the median nerve, and the ulnar nerve, as well as the time to onset of paralysis. Concentrations of mepivacaine in venous blood did not differ significantly. We conclude that alkalinized mepivacaine offers the advantage of quicker onset of more profound blockade in several terminal nerve distributions.
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PMID:Alkalinization of mepivacaine for axillary block. 153 17

This study compared the effectiveness of 0.5% ropivacaine and 0.5% bupivacaine for brachial plexus block. Forty-eight patients received a subclavian perivascular brachial plexus block for upper-extremity surgery. One group (n = 24) received ropivacaine 0.5% (175 mg) and a second group (n = 24) received bupivacaine 0.5% (175 mg), both without epinephrine. Onset times for analgesia and anesthesia in each of the C5 through T1 brachial plexus dermatomes did not differ significantly between groups. Duration of analgesia and anesthesia was long (mean duration of analgesia, 13-14 h; mean duration of anesthesia, 9-11 h) and also did not differ significantly between groups. Motor block was profound, with shoulder paralysis as well as hand paresis developing in all of the patients in both groups. Two patients in each group required supplemental blocks before surgery. Ropivacaine 0.5% and bupivacaine 0.5% appeared equally effective in providing brachial plexus anesthesia.
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PMID:A comparison of ropivacaine 0.5% and bupivacaine 0.5% for brachial plexus block. 200 42

A case of paresis of the abducens nerve following spinal analgesia is described. Cranial nerve paresis is a rare complication of spinal analgesia although described for all cranial nerves except nos. 1, 9 and 10. It is very useful to know that cranial nerve paresis after spinal analgesia often occurs after a delay of several days, and that treatment is unnecessary because symptoms nearly always disappear spontaneously in about 2-4 months.
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PMID:[Abducens paresis, a rare complication to spinal analgesia]. 205 33

To determine the effect of carbonation of lidocaine, a comparison of 1.0% lidocaine hydrochloride (HCl) and 1.1% lidocaine hydrocarbonate (CO2), both with 1:200,000 epinephrine, was made in this study of 50 patients receiving interscalene brachial plexus blocks. Sensory block was determined by the response to pinprick in the C2-T2 dermatomes, while motor block was assessed by the development of paresis and paralysis at the shoulder and hand. The percentage of patients developing analgesia (decreased sensation to pinprick) and anesthesia (total absence of sensation to pinprick) at each dermatome level as well as the percentage of patients developing motor block was not significantly different between the two forms of lidocaine. The initial onset of analgesia [lidocaine HCl, 4.0 +/- 2.4 (SD) minutes; lidocaine CO2, 4.3 +/- 3.8 (SD) minutes] and anesthesia [lidocaine HCl, 10.1 +/- 5.7 (SD) minutes; lidocaine CO2, 7.8 +/- 4.4 (SD) minutes] did not differ significantly between the two groups. At the individual dermatomes, there was no difference in the onset of analgesia except at one dermatome level, C7, which was near the level of local anesthetic injection. Anesthesia onset in each dermatome as well as the onset of motor block did not differ between the two groups. It is concluded that lidocaine CO2 does not offer any significant clinical advantage over lidocaine HCl in interscalene brachial plexus block.
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PMID:Lidocaine hydrocarbonate is not superior to lidocaine hydrochloride in interscalene brachial plexus block. 207 84

A new local anaesthetic, ropivacaine hydrochloride, was used in a concentration of 0.5 per cent in 32 patients receiving a subclavian perivascular block for upper extremity surgery. One group (n = 15) received 0.5 per cent ropivacaine without epinephrine and a second group (n = 17) received 0.5 per cent ropivacaine with epinephrine in a concentration of 1:200,000. Anaesthesia was achieved in 87 per cent of the patients in both groups in all of the C5 through T1 brachial plexus dermatomes. Motor block was profound with 100 per cent of patients in both groups developing paresis at both the shoulder and hand and 100 per cent developing paralysis at the shoulder. There was a rapid initial onset of sensory block (a mean of less than four minutes for analgesia) with a prolonged duration (a mean of greater than 13 hr of analgesia). The addition of epinephrine did not significantly affect the quality or onset of sensory or motor block. The duration of sensory block was reduced by epinephrine at T1 for analgesia and at C7, C8, and T1 for anaesthesia. The duration of sensory block in the remaining brachial plexus dermatomes as well as the duration of motor block was not effected by epinephrine. There was no evidence of cardiovascular or central nervous system toxicity in either group with a mean dose of 2.5-2.6 mg.kg-1 ropivacaine.
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PMID:Brachial plexus block with a new local anaesthetic: 0.5 per cent ropivacaine. 222 87

Arthropathies develop in 15-20% of post-stroke paresis patients. A complex of rehabilitative measures including physical therapy (transcutaneous stimulation analgesia, heating etc.), kinesitherapy and anabolic hormones can prevent contractures if applied at the early rehabilitative stage.
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PMID:[Prevention of contractures in post-stroke arthropathies]. 248 14


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