Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Opioid analgesics were used in 282 patients on the first-third day after heart, lung and abdominal surgery. The main indication for their use was pain syndrome. Adequate analgesia with tramal, nubain and moradol was noted in 73, 76 and 81% of cases. In marked pain syndrome after thoracotomy the most effective agents were moradol and morphine. Computer monitoring of the respiratory function in tramal analgesia has shown a decrease in lung ventilation, esophageal pressure, inhalation volume, O2 production. Tramal, nubain and moradol in analgesic doses did not inhibit respiration. In adequate analgesia there was a decrease in lung ventilation which was not accompanied by shifts in acid-base balance of the arterial blood. The above analgesics had no considerable effect on systemic hemodynamics, though the use of tramal decreased systemic blood pressure and the use of moradol decreased systemic blood pressure and total peripheral vascular resistance. Tramal was most effective for synchronization of spontaneous respiration with a lung ventilation device in prolonged ventilation, as well as for the arrest of muscular tremor in the postoperative period. Tramal was effective in 95% of patients in the early post-anesthesia and postoperative period.
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PMID:[Clinical aspects of the use of nubain, tramal and moradol in patients in the early postoperative period]. 141 95

In a single-blinded study, the effects of skin desensitization by topical anesthesia (4% xylocaine) on six patients who had essential tremor were investigated. Resting hand tremor was monitored using an accelerometer and multiple surface electromyograms. The amplitude and frequency characteristics of the oscillations were determined using spectral analysis. Topical anesthesia significantly suppressed the tremor amplitude and the associated electrical activity in all patients: the mean tremor amplitude was reduced by 40%. No changes in the frequencies of the essential tremors were detected.
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PMID:Effects of topical anesthesia on essential tremor. 152 17

The purpose of this article is to describe the phenomenon of postanesthesia shaking (PS) and discuss its significance to the patient recovering from anesthesia, and to review the literature on the subject. Based on this review, future studies are recommended to replicate previous work, and to provide a more comprehensive picture of PS. Results of research may determine further treatment for PS.
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PMID:Postanesthesia shaking: a review. 153 73

This case demonstrates focal neurologic deficit mimicking stroke with underlying hepatic encephalopathy. Unilateral weakness in patients with hepatic encephalopathy has not been previously described in the English language literature. A 46-yr-old white woman was admitted to an acute care hospital for left shoulder manipulation, underwent general anesthesia and appeared to have had a right cerebrovascular accident. At transfer to the rehabilitation hospital, in addition to the left hemiparesis, there were inconsistencies in the neurologic examination and signs of cognitive impairment and liver failure. The patient's response to an intensive, multidisciplinary inpatient rehabilitation program along with treatment of the liver dysfunction led to resolution of left-sided weakness and flapping tremor with independence in ambulation and activities of daily living. Relevant literature is reviewed. A thorough history and physical examination with liver function assessment should always be performed in patients with cerebrovascular accident and unusual recovery.
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PMID:Hepatic encephalopathy mimicking stroke. A case report. 155 31

Spinal anesthesia was given to a patient with right femur fracture and Parkinson's disease (PD). Although sufficient analgesia was obtained up to L1 level after spinal anesthesia, the muscular rigidity remained. Furthermore, tremor of the upper extremities continued. After administering dantrolene sodium (DT) intravenously, these untoward features were abolished. These findings suggest that DT abolishes rigidity and tremor in PD, and is useful for the management of anesthesia for a patient with PD.
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PMID:[Rigidity abolished by intravenous dantrolene in a patient with Parkinson's disease under spinal anesthesia]. 156 May 88

The cause of postanesthesia shaking (PS) is unknown. PS develops spontaneously and unpredictably in up to 67% of patients emerging from general anesthesia, and it continues for minutes to hours when not treated with medications or radiant heat lamps. The purposes of this study were to (1) examine whether butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN), meperidine (Demerol; Winthrop, NY, NY), and morphine are differentially effective in suppressing PS, (2) compare PS suppression by sex, and (3) determine time to PS development. PS, measured on a 0 to 3 visual scale, developed in 120 of 533 patients (23%). Medication treatment was initiated for 66 of 120 patients by PACU nurses following standard policies and procedures for intravenous doses of 1 mg butorphanol (n = 12), 15 to 30 mg meperidine (n = 18; n = 23), or 2 to 4 mg morphine (n = 13). Treatment effect was measured in units on a 0 to 2 visual scale. By t test, butorphanol is more effective within 2 minutes than meperidine for suppressing shaking alone (P less than .02) or shaking among patients also complaining of pain (P less than .02). Morphine does not relieve shaking. The chi 2 test indicates women suppress PS more rapidly than men (P less than .01), and PS develops within 5 minutes of PACU arrival (P less than .001). Findings suggest that butorphanol is an alternative PS treatment to meperidine, since it relieves shaking within 2 to 5 minutes without producing nausea, vomiting, or recurrence of shaking.
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PMID:Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine. 157

Microelectrode recording was carried out in the thalamic reticularis nucleus (Rt) during 51 stereotaxic operations performed in locally anesthetized dyskinetic patients. The spontaneous activity (SA) of 426 units was studied by means of computer processing techniques. Three types of unit (A, B, C) were shown to exist in Rt: with irregular low-frequency (0-10/sec) discharges (A type, 51%); bursting in short trains (10-30 msec) with unstable rhythmic pattern (2-5/sec; B type, 42%); presenting long duration (0.1-2 sec) high frequency bursts and relatively constant interburst silences (80-150 msec; C type, 7%). During short-term anesthesia A unit discharges disappeared; on the contrary the rhythmic bursts of B neurons were synchronized and presented a more stable frequency. The 3 types of cell were present in the whole Rt. However, a number of discharge characteristics (frequency, variation of rhythm) of A and B units changed significantly with the position of the cells in the Rt. No relationship was found between the frequencies of the rhythmic bursts and the parkinsonian tremor. With the use of a multiparametric statistical procedure, a relation was, however, found between the intensity of the peripheral tremor and the stability of the average frequency of the B type rhythmic bursts. The possible origins of rhythmic bursts of B and C neurons are discussed.
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PMID:Unit activity in human thalamic reticularis nucleus. I. Spontaneous activity. 171 27

Butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN) is an analgesic possessing mixed agonist-antagonist activity at opiate receptors. Receptor specificity has been used to limit respiratory depression, gastrointestinal side effects, and reduce the risk of dependency. Theoretically it offers an advantage over traditional opiates such as morphine and meperidine in the treatment of moderate pain. Butorphanol has been used as a preoperative sedative and analgesic, as a supplement to balanced anesthesia, and for suppression of postanesthesia shaking. Other recognized uses include obstetric analgesia during labor and relief of moderate postpartum pain. In addition, butorphanol has been used effectively for conscious sedation. Its lack of euphoric effects may be useful in emergency medicine for clinical populations prone to drug-seeking behavior. Butorphanol has been used more recently for epidural analgesia or for intravenous patient-controlled analgesia when allergies to opiates exist. Since butorphanol is not a controlled substance, its use can reduce administrative liability for abuse and can lower the number of distribution records associated with Schedule II narcotics.
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PMID:Butorphanol tartrate (stadol): a review. 184 91

While the cause of postanesthesia shaking (PS) remains unknown, nurses traditionally believe that the etiology of PS is hypothermia. Two theoretical constructs have been proposed to describe the development of PS. The first is based on classic thermoregulation theory. The second is based on spinal reflex hyperactivity. The purpose of this comparison study was to determine if significant differences in postoperative temperature, as well as change in preoperative to postoperative temperature, exists between patients who develop and who do not develop PS. The study also examined the difference in postoperative temperature between women and men. Postoperative axillary temperature was measured on admission to the PACU. The nonprobability convenience sample consisted of patients between the ages of 18 and 89 years who were extubated and breathing spontaneously following general anesthesia. PS developed in 120 of 533 patients. By t-test analysis, there was no statistical significant difference between groups in postoperative mean temperature (P greater than .10) or in preoperative to postoperative mean temperature change (P greater than .40). The group that developed PS had a narrower and higher range of postoperative temperature and a smaller preoperative to postoperative temperature change than those who did not develop PS. In both groups, 52% of the patients were hypothermic (less than 35 degrees C[less than 95 degrees F]) on PACU admission. Women had lower postoperative mean temperature than men (P less than .05). Findings indicate that temperature on PACU admission is not a variable of difference between groups of patients who develop or who do not develop PS. As postoperative temperature decreases, the incidence of PS does not increase.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Patients who develop postanesthesia shaking show no difference in postoperative temperature from those who do not develop shaking. 186 76

We tested the hypotheses that systemic absorption of epidural lidocaine: (1) contributes to the shivering-like tremor seen during epidural anesthesia by causing central nervous system disinhibition of spinal reflexes, or (2) activates or alters thermoregulatory mechanisms. In a double-blind, placebo, cross-over study, nine healthy volunteers were given intravenous lidocaine (or saline) to approximate the plasma levels of lidocaine achieved during epidural anesthesia for major abdominal surgery. Five volunteers were studied in a warm room (to test for nonthermoregulatory tremor), and four volunteers were studied in a cold room (to test the effects of lidocaine on normal thermoregulation). Central temperatures, peripheral vasoconstriction, tremor and clonus were unaffected by intravenous lidocaine. We conclude that the systemic absorption of epidural lidocaine does not contribute to tremor or shivering by these mechanisms.
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PMID:Intravenous lidocaine does not cause shivering-like tremor or alter thermoregulation. 191 98


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