thiopental and Movement-Disorders

Excitatory movements have been observed during induction of anesthesia with etomidate, thiopental, methohexital, and propofol. We studied the frequency of these excitatory effects and correlated movements with electroencephalographic (EEG) findings in 67 unpremedicated patients (mean age 66.1 yr, range 45-82 yr). Excitatory effects, including myoclonus, tremor, and dystonic posturing, occurred in 86.6% of patients receiving etomidate; 69.2% of the patient responses were myoclonic. Multiple spikes appeared on the EEG in 22.2% of the etomidate patients. The frequency of excitatory effects was 16.6% after thiopental, 12.5% after methohexital, and 5.5% after propofol. None of the patients receiving thiopental, methohexital, or propofol developed myoclonic or seizure activity. In most patients, the excitatory movements were coincident with the early slow phase of the EEG which corresponds to the beginning of deep anesthesia. We conclude that perhaps caution should be exercised when administering etomidate to patients with a history of seizures as the myoclonic activity is associated with seizure activity. The incidence of excitatory movements after administration of propofol is very low.

Topics: Aged; Aged, 80 and over; Anesthesia, Intravenous; Dystonia; Electroencephalography; Etomidate; Humans; Methohexital; Middle Aged; Movement Disorders; Myoclonus; Ophthalmologic Surgical Procedures; Propofol; Thiopental; Tremor

Topics: Abdominal Muscles; Adult; Aged; Anesthesia, Intravenous; Electromyography; Fasciculation; Humans; Intubation, Gastrointestinal; Male; Middle Aged; Movement Disorders; Pressure; Stomach; Succinylcholine; Thiopental; Tubocurarine

Thiopentone doses corresponding to 5.238 mg x kg-1, that is 2UD95 (UD95:unconsciousness dose 95) inhibit the intensity of succinylcholine-induced fasciculations compared with UD95. Alfathesin doses corresponding to 0.570 mg x kg-1, also 2UD95 (calculated as alphaxalone at a concentration of 9 mg/ml in alfathesin), do not have any greater effect on the degree of fasciculations compared to UD95. Furthermore, neither induction agent influences the incidence, distribution and duration of succinylcholine-induced myalgias. The inhibition of the degree of fasciculations caused by thiopentone is believed to be a consequence of a postsynaptic depressant effect of thiopentone at the neuromuscular junction. The evaluation of the degree of succinylcholine-induced fasciculations must take into consideration the dose of thiopentone administered at induction of anaesthesia.

Topics: Adult; Alfaxalone Alfadolone Mixture; Dose-Response Relationship, Drug; Drug Interactions; Fasciculation; Female; Humans; Middle Aged; Movement Disorders; Muscular Diseases; Postoperative Period; Succinylcholine; Thiopental

Topics: Adolescent; Adult; Fasciculation; Female; Glaucoma; Humans; Intraocular Pressure; Movement Disorders; Succinylcholine; Thiopental; Time Factors

Topics: Adolescent; Adult; Anesthesia, Dental; Brain Damage, Chronic; Carbon Dioxide; Child; Child, Preschool; Electroencephalography; Epilepsy; Female; Halothane; Humans; Injections, Intramuscular; Injections, Intravenous; Ketamine; Male; Methohexital; Movement Disorders; Oxygen; Partial Pressure; Seizures; Thiopental