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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a randomized, double-blind, placebo-controlled study, the safety, efficacy and feasibility of oral midazolam premedication in children were evaluated in an ambulatory surgery unit. Eighty unmedicated children (ASA PS I or II, ages 1-6 yr) were randomly assigned to one of four groups receiving midazolam 0.5, 0.75, or 1.0 mg.kg-1 or a placebo 30 min before separation from parents. Heart rate, systolic blood pressure, arterial oxygen saturation, respiratory rate, sedation and anxiolysis scores were recorded before premedication, every five minutes for 30 min and then during induction of anaesthesia and recovery. We found that heart rate, systolic blood pressure, arterial oxygen saturation and respiratory rate were unchanged during the study. Sedation and anxiolysis scores in the midazolam-treated groups were greater than those in the placebo group and that anxiolysis at the time of separation from the parents was judged excellent in 80-90% of the children who received midazolam. However, sedation and anxiolysis did not differ among the three midazolam groups. Mean times to discharge from hospital were similar for all four groups. The side effects, loss of balance and head control, blurred vision and dysphoric reactions were observed only in the 0.75 and 1.0 mg.kg-1 midazolam groups. We conclude that oral midazolam 0.5 mg.kg-1 is a safe and effective premedication and that 0.75 and 1 mg.kg-1 while offering no additional benefit, may cause more side effects.
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PMID:Premedication of children with oral midazolam. 164 74

Postoperative psychomotor and cognitive recovery were assessed after anaesthesia induced by either propofol or thiopentone, and maintained with nitrous oxide and halothane in 40 unpremedicated dental patients. Performance was shown to be impaired one hour postoperatively for the whole sample in hand-eye coordination (p less than 0.001), reaction time (p less than 0.001) and digit span (p less than 0.05). There was evidence of impairment at 3 hours postoperatively in reaction time (p less than 0.05) and ataxia (p less than 0.01). Performance also deteriorated in the dexterity and aiming tasks. Patients reported significantly less clumsiness by 24 hours in blurred vision and shivering (p less than 0.05) and by 48 hours less coughing (p less than 0.05). However, there was no significant difference between groups. No evidence showed that recovery in the propofol group was faster, so it was concluded that induction with propofol offered no advantage when anaesthesia is maintained with nitrous oxide and halothane for the periods of time reported in this study.
Anaesthesia 1989 Mar
PMID:Propofol-induced anaesthesia. Double-blind comparison of recovery after anaesthesia induced by propofol or thiopentone. 278 49

The use of trans-sphenoidal pituitary alcohol injection was assessed in a district general hospital for the treatment of diffuse bilateral cancer pain in 26 patients. Fourteen patients received a total of 43 injections. Hormonal and non-hormonal dependent cancers were treated, with complete pain relief in ten patients and partial relief in a further seven patients. The duration of relief was variable, and usually less than 6 weeks, although two patients had complete pain relief for 5 and 7 months respectively. No cases of meningitis or cerebrospinal fluid rhinorrhoea occurred. Nasal antiseptics and vasoconstrictors were not used. Temporary pupil dilatation occurred in eight patients, of whom one had prolonged blurred vision for small print. Transient diabetes insipidus was common (53%), although only five patients needed permanent treatment. Death from their disease occurred in 65% of patients within 3 months. Survival was shorter than in series from specialist centres, suggesting later referral for pain relief. The technique is an inexpensive and valid form of treatment for cancer pain in a district hospital, but should not be undertaken lightly in view of the possible complications.
Anaesthesia 1984 Jun
PMID:Pituitary alcohol injection for cancer pain. Use in a district general hospital. 620 49

In a random cross-over double-blind trial, the effects of intravenous physostigmine salicylate (2.0 mg) and placebo were observed in seven healthy volunteers 10 minutes after the intravenous administration of 1.5 mg/kg of ketamine. Recovery time was significantly shorter after physostigmine than after placebo. Nystagmus and blurred vision, which followed ketamine anesthesia, disappeared more rapidly when physostigmine was given. This study confirms previous observations that physostigmine counteracts some of the manifestation of ketamine aftereffects which resemble the so-called central anticholinergic syndrome. Nausea and vomiting were significantly more frequent after physostigmine administration.
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PMID:Physostigmine antagonizes ketamine. 699 46

A 45-year-old male experienced a transient ischemic attack manifesting as left blurred vision and right hemiparesis. Angiography demonstrated an extracranial internal carotid artery aneurysm at the entrance of the carotid canal just above the C-1 vertebral arch. Intraluminal occlusion of the aneurysm was achieved with mechanically detachable coils under local anesthesia, and the carotid flow was preserved. There was no complication during or following the procedure. Treatment of aneurysms using detachable coils is an important alternative to surgical treatment when surgical access to the lesion is difficult.
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PMID:Endovascular treatment of an extracranial internal carotid artery aneurysm at the skull base with mechanically detachable coils--case report. 853 31

We examined if patient-controlled analgesia (PCA) with i.v. morphine provided comparable postoperative analgesia after hysterectomy as extradural morphine, without increasing the incidence of side effects. The study (n = 40) was randomized and double-blind. An extradural catheter was inserted before surgery and anaesthesia was standardized. The extradural group received extradural morphine 0.06 mg kg-1 by the end of surgery and a second dose 6 h later. The i.v. group received an i.v. infusion of morphine 0.2 mg kg-1 after surgery. PCA with morphine 0.04 mg kg-1 i.v. was used in both groups. Pain relief (VAS), side effects and cognitive functions were evaluated for 18 h. Plasma samples were obtained for analysis of morphine concentrations. Mean consumption of PCA morphine was 2.4 mg h-1 for the i.v. group and 1 mg h-1 for the extradural group. Despite unlimited access to morphine, the i.v. group had higher VAS scores as the extradural group (P < 0.001). Plasma concentrations of morphine varied 8-10-fold in both groups. In the i.v. group itching, tiredness, blurred vision and vertigo correlated with cumulative consumption of i.v. morphine whereas in the extradural group this correlation existed only for tiredness. Both groups showed reduced ability to perform tests of cognitive function, indicating a central effect of both i.v. and extradural morphine, despite markedly lower plasma morphine concentrations in the extradural group.
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PMID:Extradural morphine gives better pain relief than patient-controlled i.v. morphine after hysterectomy. 905 97

Acute angle-closure glaucoma is a rare complication of surgery. We experienced a case of postoperative acute glaucoma after total hip replacement under general anesthesia. A 49-year-old female without signs or symptoms of glaucoma was premedicated with the intramuscular administration of secobarbital, atropine and ranitidine. Following rapid induction with thiopental and vecuronium, anesthesia was maintained with N2O-O2-sevoflurane. PGE1 was administered intravenously for induced hypotension during the surgery. Hemorrhagic shock with a systolic blood pressure of 60 mmHg continued for 15 min during the surgery. Large amounts of fluid and ephedrine were required for treating this hypotensive episode. Vecuronium was reversed by bolus injection of neostigmine and atropine at the end of surgery. Soon after recovery from anesthesia, she complained of pain and blurred vision in her both eyes. The consulting ophthalmologist made a diagnosis of acute glaucoma due to high intraocular pressure (IOP). Treatment with glycerol and pilocarpine had no effect on the elevated IOP. The laser iridotomy performed on her at 5th and 7th post-operative days improved her vision completely. The post-operative glaucoma may cause serious permanent loss of vision. An early diagnosis of this post-operative complication and its treatment with drugs and surgery should be emphasized.
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PMID:[Acute angle-closure glaucoma after total hip replacement surgery]. 922 89

Tramadol is a weak centrally acting analgesic and it might provide efficacious postoperative pain relief with minimal sedative effects in the use of intravenous patient-controlled analgesia (PCA). Sixty women scheduled to undergo microvascular breast reconstruction under standard general anaesthesia were enrolled in a study on the performance of patient-controlled analgesia with tramadol or morphine with special emphasis on drug- and technique-related side-effects. Seven patients were re-operated within the same day, leaving 25 patients in the tramadol group and 28 in the morphine group for comparison. When postoperative pain occurred, loading doses of either 10 mg tramadol or 1 mg morphine intravenous increments were administered in a double-blind fashion until the pain control was judged to be satisfactory by the patient. After that the patients received tramadol or morphine by a PCA apparatus (lockout 5 min, tramadol 450 microg kg-1, morphine 45 microg kg-1 bolus). In addition, all patients received 500 mg paracetamol rectally, three times a day. The potency ratio of tramadol to morphine was found to be between 8.5 : 1 (loading) and 11 : 1 (PCA). There was neither a significant difference between the groups in the overall satisfaction of the analgesic medication nor in the visual analogue and verbal rate scales for pain. Women in the tramadol group had more nausea and vomiting during the administration of loading doses (P < 0.05) and more patients in the tramadol group (7) than in the morphine group (3) (NS) wanted to discontinue the PCA therapy before the end of the study due to nausea. Sedation or blurred vision prevented the performance of the psychomotor tests in 22 and 32% of the tramadol and morphine patients, respectively. The remaining patients performed similarly in the Digit Symbol Substitution Test. In women receiving intravenous PCA for analgesia after microvascular breast reconstruction tramadol and morphine provided comparable postoperative analgesia with similar sedative effects. However, tramadol was associated with a disturbingly high incidence of nausea and vomiting.
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PMID:Comparison of intravenous patient-controlled analgesia with tramadol versus morphine after microvascular breast reconstruction. 1096 47

Facial hyperhidrosis (HH) is more difficult to diagnose than other forms of focal HH because many secondary causes must be considered. Pharmacologic treatment with botulinum toxin type A (BTX-A) would be appropriate for patients with severe facial HH that limits their lifestyle (eg, blurred vision from sweating, distressed with their appearance). The main concern with administering BTX-A for facial HH is aesthetics, such as facial asymmetry or brow ptosis. This article describes best practice techniques for BTX-A (Botox) in patients with facial HH, including suggested dilution and syringe selection, injection technique, dose and injection grid, and anesthesia recommendations. Special considerations and navigating the insurance reimbursement process also are discussed.
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PMID:Facial hyperhidrosis: best practice recommendations and special considerations. 1759 98

The posterior superior alveolar nerve (PSAN) is a major sensory branch of the maxillary division of the trigeminal nerve. A PSAN block is a dental nerve block used for profound anesthesia of the maxillary molars. Complications arising from the PSAN block include hematoma formation, transient diplopia, blurred vision, and temporary blindness. This article presents a case of temporary paresis in the lateral pterygoid muscle following a PSAN block that utilized a 27-gauge long needle. The anatomical parameters and pathogenesis of such a complication are reviewed.
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PMID:Transitory paresis of the lateral pterygoid muscle during a posterior superior alveolar nerve block--a case report. 1805 May 79


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