Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of the surgical and postoperative records of 127 revascularization procedures performed on 82 children with Moyamoya disease was done to evaluate changes we made in anesthetic management in response to perioperative complications. From 1982 to 1996, out of 82 children who underwent revascularization surgery at our hospital, five developed perioperative complications. One developed circulatory instability during surgery; the cause seemed to be a depth of anesthesia insufficient for preventing surgical stress. To rectify this problem, an increased dose of fentanyl was used to improve the maintenance of anesthesia. Four patients developed cerebral infarction during the early postoperative period due, in part, to inadequate management of postoperative pain. We began to administer supplemental doses of meperidine to patients after they emerged from anesthesia to provide better control of postoperative pain. Our review confirmed the effectiveness of these measures. The data suggest that during the perioperative management of children with Moyamoya disease, close attention should be paid to balancing the patients' anesthetic state against surgical stress and providing adequate postoperative analgesia.
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PMID:Anesthetic management of children with moyamoya disease. 940 18

A 34-year-old woman 22 weeks pregnant suffered cerebral hemorrhage, requiring admission to the intensive care unit and mechanical ventilation. She recovered without sequelae. The diagnosis was moyamoya disease and she was scheduled for elective cesarean delivery at 38 weeks of gestation. After appropriate preoperative study and complementary testing (echocardiogram, computerized axial tomography of the brain and determination of anti-cardiolipin and other antibodies, which were normal) the patient was given intradural anesthesia with 15 mg of 0.5% bupivacaine and 24 micrograms of fentanyl, with continuous monitoring of blood pressure, tympanic temperature and neurological variables. Warm intravenous fluids and ephedrine (100 to 250 micrograms/min) were perfused. No noteworthy neurological events or hemodynamic changes occurred during or after surgery. Postoperative analgesia was provided with 2 mg/12 h of morphine through an epidural catheter.
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PMID:[Anesthesiologic implications of moyamoya disease]. 958 Apr 60

We present the case of a parturient with moyamoya disease admitted to the hospital for elective cesarean section. Combined spinal and epidural technique was chosen because it allows better analgesia than epidural anesthesia and more hemodynamic stability than either general or spinal anesthesia. Ropivacaine was the local anesthetic of choice for the epidural portion because of the wide sensory-motor dissociation, thus preserving adequate respiration in the case of a high block.
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PMID:Combined spinal and epidural anesthesia for cesarean section in a parturient with moyamoya disease. 1040 27

Chorea gravidarum is uncommon movement disorder of pregnancy, characterized by involuntary, abrupt, non-rhythmic movements. It can be idiopathic or secondary to the underlying pathology. A 28-year-old, primigravida woman who was 8 weeks and 6 days of gestation presented with a history of involuntary choreiform movements in the left side limbs and facial twitch for 2 weeks. The symptoms started just after onset of severe emesis gravidarum. There was no meaningful medical history or family history, and she was taking no regular medication. Magnetic resonance imaging of the brain revealed moyamoya disease. The symptoms, as well as the hyperemesis gravidarum, improved with gestational age; however, they were sustained up to 30 weeks of gestation. She delivered 2.61 kg, healthy male neonate at 40 weeks' pregnancy by vaginal delivery under epidural analgesia. After 3 years later, she got pregnant again, and delivered at 41 weeks of pregnancy without complication. She experienced similar but milder symptoms to that of the first pregnancy until the late second trimester. After the delivery, full evaluation was lost due to her refusal. In this report, we present the case of a patient with chorea gravidarum in which moyamoya disease acts as an etiologic factor and a review of literature with management proposal.
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PMID:Consecutive pregnancy with chorea gravidarum associated with moyamoya disease. 1932 53