Degree Of Akinesia Research Articles

Anti-Parkinsonian Activity of Hemantane on a Model of Hemiparkinsonian Syndrome in Rats.

Hemantane demonstrated a pronounced antiparkinsonian activity in the model of hemiparkinsonian syndrome provoked in rats by unilateral intracerebral injection of 6-hydroxydopamine, which was comparable to efficacy of levodopa in decreasing the duration of cataleptogenic state and the degree of akinesia of the contralesional forelimb assessed in the cylinder test. In the stepping test, hemantane exerted a long-term effect in contrast to levodopa, which diminished its beneficial action to the treatment day 21. In the swing test, the behavior normalized only by hemantane.

Regional Anesthesia and Eye Surgery

Regional Anesthesia and Eye Surgery

Ropivacaine in Peribulbar Anesthesia – Vasoconstrictive Properties

Peribulbar anesthesia can reduce ocular blood flow (OBF) by increasing intraocular pressure (IOP) or due to the action of drugs. Ropivacaine has low toxicity and intrinsic vasoconstrictive properties, yet to be proven on the ocular vasculature. Measurements of ocular pulse amplitude (OPA) allow the indirect evaluation of the OBF. The objective of the present study was to evaluate through the OBF the vasoconstrictive properties of ropivacaine in peribulbar anesthesia. Forty eyes undergoing peribulbar anesthesia with 7 mL of anesthetic solution without vasoconstrictor were randomly divided into two groups: ropivacaine (n = 20) and bupivacaine (n = 20). The IOP, ocular perfusion pressure (OPP), OPA, hemodynamic parameters, and the degree of akinesia before and 5 and 10 minutes after the blockade were evaluated. A dynamic contour tonometer was used to evaluate ocular parameters. Sedation was similar in both groups. A significant variation in hemodynamic parameters and intensity of the motor blockade was not observed between groups. Differences in IOP, OPP, and OPA (p < 0.05) were observed between both groups at 5 and 10 minutes. The variation of IOP at 5 and 10 minutes was -0.88% and -4.54%, respectively with ropivacaine, and 17.61% and 16.56% with bupivacaine. The change in OPP after 5 and 10 minutes was 1.5% and 4.2% with ropivacaine, and -7% and -6% with bupivacaine. Ocular pulse amplitude varied -55.59% and -59.67% with ropivacaine at 5 and 10 minutes, and -34.71% and -28.82% with bupivacaine. Ropivacaine reduced more intensely the ocular pulse amplitude despite little changes in IOP and OPP. The reduction in ocular blood flow caused by ropivacaine can be attributed to its vasoconstrictive effect.

Subjective visual perceptions during vitreoretinal surgery under local anaesthesia

To evaluate the visual experiences of patients during vitreoretinal surgery under local anaesthesia (LA). Prospective questionnaire survey of 80 patients within 30 min of completion of vitreoretinal surgery under LA. Preoperative visual acuity, surgical procedure and its duration, efficacy of the local block, as well as intraoperative perceptions of flashes, colours, movements, and seeing instruments were documented. A sub-Tenon's block was performed in 62/80 (77.5%) and a peribulbar block in the remainder. Overall, 72 (90%) of patients perceived light at some stage during their surgery. Of these, 51 (70.83%) observed movements, 45 (62.5%) saw colours, 38 (52.77%) saw instruments, and 24 (33.33%) saw flashes. The commonest observations were colourful swirls, black pipes, and the colour red. Most patients found these experiences pleasant or bearable; two found them frightening, and four would like to have been warned preoperatively about them. Preoperative visual acuity, diagnosis, gender of the patient, degree of akinesia, and the duration of surgery did not associate with visual perceptions. Logistic regression analysis showed that younger people were more likely to experience flashing lights (P=0.03) and to see instruments (P=0.04), patients having a sub-Tenon's block to perceive light (P=0.005), and those who did not receive awake sedation were more likely to see instruments (P=0.04). Visual experiences are common during vitreoretinal surgery undertaken under LA. Where appropriate, patients should be forewarned about these experiences and reassured that they are not normally frightening.

P39.2 Motor cortical excitability seems to change with degree of akinesia in Parkinson’s disease

P39.2 Motor cortical excitability seems to change with degree of akinesia in Parkinson’s disease

Comparison of articaine and bupivacaine/lidocaine for single medial canthus peribulbar anaesthesia

In a single-centre, randomized, double-blind study, we compared the efficacy of 2% articaine with that of a mixture of 0.5% bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataract surgery, using a single medial canthus injection technique. Eighty-two patients were allocated randomly to receive 7-9 ml of a mixture of 0.5% bupivacaine and 2% lidocaine or an equal volume of 2% articaine with 1:200,000 epinephrine. Hyaluronidase 30 iu ml(-1) was added to both solutions. The degree of akinesia was scored 1, 5 and 10 min after the block, at the end of surgery and at discharge from the day case unit. Primary outcome measures were the difference in ocular movement scores 5 min after block and the need for supplementary inferolateral injections. There was greater akinesia in the articaine group at 5 min (P=0.01). Ten patients (24%) in the articaine group and 21 patients (51%) in the bupivacaine/lidocaine group required a supplementary injection (P=0.02). The mean (SD) volume of local anaesthetic required to achieve adequate block for surgery was 9.7 (2.1) ml in the articaine group and 11.0 (2.2) ml in the bupivacaine/lidocaine group (P=0.01). There was a faster offset of akinesia after surgery in the articaine group (P=0.01). There were no differences between groups in the incidence of reported pain or of minor complications. In our study, 2% articaine with 1:200,000 epinephrine was safe and efficacious for single medial canthus peribulbar anaesthesia.

Peribulbar anaesthesia during keratoplasty: a prospective study of 100 cases

AIMSA prospective study was carried out in order to evaluate the efficacy and safety of peribulbar anaesthesia during keratoplasty and to describe surgical conditions.METHODSOf 137 consecutive keratoplasties, 100 (73%) were...

Sub-Tenon’s anaesthesia: an efficient and safe technique

AIMTo evaluate sub-Tenon’ s anaesthesia as an alternative to peribulbar anaesthesia.METHODS109 consecutive patients listed for various eye operations (including cataract, trabeculectomy, and vitrectomy) under peribulbar anaesthesia were operated on under...

A correlation study between blink reflex habituation and clinical state in patients with Parkinson's disease

The neurologic states and activities of daily life of patients with Parkinson's disease were evaluated using a rating scale with subitems, and subsequently the neurologic disturbance scores and the daily activity impairment scores were obtained. Subjects consisted of 19 normal controls, and 55 ambulatory patients without marked dyskinesia who were on various anti-parkinsonian drugs. Blink reflex was elicited by paired electrical stimulation over the supraorbital nerve. The interval time between the conditioning stimulation and the test stimulation was set at 200 ms, and 5 serial ipsilateral maximal R 2 amplitudes on the stimulated side were measured. The mean of the paired maximal R 2 amplitude ratio (test/conditioning), expressed as a percentage, was defined as the habituation index. The habituation indices in normal controls and those with Parkinson's disease were 17.1 ± 7.6 and 51.9 ± 29.3, respectively ( P < 0.01). The degree of akinesia, rigidity, balance/gait and dysarthria was positively correlated with the habituation index ( P < 0.01), while tremor was not. On the whole the habituation index was found to have a significant correlation not only with the neurologic disturbance score but also with the daily activity impairment score ( P < 0.01).

Ventricular somatostatin-like immunoreactivity in patients with basal ganglia disease.

The concentrations of somatostatin-like immunoreactivity (SLI) in lateral ventricular fluid of patients with extrapyramidal motor disease were determined by specific radio-immunoassay. Mean SLI levels were significantly lower in patients with Parkinson's disease (mean +/- SEM); 42.9 +/- 2.9 fmol/ml) and in patients with dystonic syndromes (39.4 +/- 3.2) than in patients with benign essential tremor (65.3 +/- 9.7). The lowest levels were found in patients with athetosis (34.7 +/- 5.4). In parkinsonian patients somatostatin levels correlated with the degree of akinesia, rigidity and autonomic disturbances.