Subject(s)
Cerebrovascular Circulation , Hallucinations/diagnostic imaging , Hallucinations/etiology , Occipital Lobe/pathology , Retinitis Pigmentosa/complications , Tomography, Emission-Computed, Single-Photon , Aged , Dominance, Cerebral , Female , Humans , Occipital Lobe/diagnostic imaging , Predictive Value of Tests , Syndrome , Vision, Low , Visual PerceptionABSTRACT
We compared the effect of fentanyl and lidocaine on pain during injection of propofol. One hundred and sixty patients premedicated with midazolam were randomly allocated to one of four groups (n = 40, respectively); Group C, propofol 2 mg.kg-1; Group F, fentanyl 0.1 mg 3 min prior to propofol; Group L, lidocaine 40 mg added to 200 mg propofol; Group FL, fentanyl 0.1 mg 3 min prior to propofol mixed with lidocaine 40 mg. Propofol was injected via a vein on the dorsum of the hand in a half of the patients in each Group or the forearm vain in the other half. The incidence of pain was significantly less in both Group F (40%) and Group L (35%) compared with Group C (80%, P < 0.01). There was no significant difference in the incidence of pain between Group F and Group L. Group FL had the least incidence of pain (5%) of all Groups. Injection via the forearm vain tended to reduce the severity of pain compared with the vain on the dorsum of the hand. The time until loss of consciousness was significantly less in the groups receiving fentanyl than the groups without fentanyl (P < 0.01). In conclusion, prior administration of fentanyl is as effective as premixing of lidocaine in preventing the pain on injection of propofol, and the simultaneous application of them may abolish the pain.
Subject(s)
Analgesics, Opioid/administration & dosage , Anesthetics, Intravenous/administration & dosage , Anesthetics, Local/administration & dosage , Fentanyl/administration & dosage , Lidocaine/administration & dosage , Pain/prevention & control , Propofol/administration & dosage , Adult , Aged , Drug Combinations , Female , Humans , Injections, Intravenous/adverse effects , Male , Middle Aged , Pain/etiology , Preanesthetic MedicationABSTRACT
We investigated the efficacy and untoward effects of low doses of propofol for intrathecal morphine-induced pruritus. Twenty gynecological and obstetric surgical patients received spinal anesthesia with 0.5% tetracaine and phenylephrine, as well as 0.2 mg morphine. Seven of them (35%) complained pruritus graded according to the treatment necessary in the postoperative period. Propofol, 10 mg or 20 mg, successfully alleviated the pruritus in 6 patients out of 7. Further treatment was not necessary in 5 of them. One patient was resistant to treatments by 20 mg of propofol and 0.1 mg of naloxone. Three patients transiently fell in sleep even after administering 10 mg of propofol. The authors conclude that low dose propofol is effective in treating intrathecal morphine-induced pruritus, although it may transiently causes hypnosis in postoperative patients.
Subject(s)
Analgesics, Opioid/adverse effects , Anesthesia, Spinal , Hypnotics and Sedatives/administration & dosage , Morphine/adverse effects , Propofol/administration & dosage , Pruritus/drug therapy , Adult , Aged , Female , Genital Diseases, Female/surgery , Humans , Hypnotics and Sedatives/adverse effects , Middle Aged , Postoperative Period , Propofol/adverse effects , Pruritus/chemically induced , Sleep Wake Disorders/chemically inducedABSTRACT
Magnetic resonance imaging (MRI) of thigh and leg muscles was performed in a patient with alcoholic myopathy showing myalgia, hypercreatine kinasemia, and hypermyoglobinemia. High signal intensities in both T1- and T2-weighted images were widely distributed in the affected muscle groups, which most likely reflected lipid accumulation. Although he had hypermyoglobinemia, MRI and muscle biopsy did not show findings of rhabdomyolysis, such as necrosis, regeneration, and edema. We suggest that the high signal intensities in this case may have indicated "prerhabdomyolysis" related to alcohol abuse and that muscle MRI is useful in the evaluation of alcoholic myopathy, mainly predicting the onset of rhabdomyolysis.
