Abstract
We performed serial neurological evaluations on 86 patients who underwent surgery for herniated lumbar disk during the first 3 hours after the end of anesthesia (isoflurane-N20-02 for 25 patients, halothane-N20-02 for 38, fentanyl-droperidol-N20-02 for 23).
At time 0, the idiomuscular response to percussion of the extensor carpi muscle was present in every patient, while tendon reflexes were always absent. Hyperreflexia was as frequent as shivering, but it took place earlier; we could determine no correlation between these two phenomena. There was no correlation between shivering and rectal temperature of the patients.
Although almost all the patients were cooperative and could correctly calculate 100–7, the post-hyperventilation-apnea test was positive in 35 patients at time 120 minutes: this suggests that many patients considered “awake” still exhibit neurological abnormalities, such as inadequate respiratory drive.
Sommario
Abbiamo sottoposto a valutazione neurologica fino a 3 ore dal termine dell'erogazione dei farmaci anestetici (Isoflurane-N20-02 per 25 pazienti, Alotano-N20-02 per 38, Fentanyl-Droperidolo-N20-02 per 23) 86 pazienti operati per asportazione di disco intervertebrale lombare erniato.
Al tempo 0 la risposta idiomuscolare da percussione del muscolo estensore del carpo era presente in tutti i case mentre erano sempre assenti i riflessi osteotendinei.
L'iperreflessia si è presentata con frequenza analoga a quella del brivido, anche se più precocemente. Non siamo stati comunque in grado di evidenziare una correlazione tra i due fenomeni. Non c'è stata relazione alcuna tra temperatura rettale e brivido. La positività alle prove di post-hyperventilationapnoea a 120 minuti in 35 pazienti, nonostante la quasi totalità della popolazione fosse in grado di collaborare ed eseguire correttamente prove di calcolo (100–7), suggerisce una persistenza di anomalie neurologische, quali l'inadeguato “drive” respiratorio, in pazienti considerati “svegli”.
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Fiacchino, F., Gemma, M., Bricchi, M. et al. Neurological examination in patients recovering from general anesthesia. Ital J Neuro Sci 13, 749–753 (1992). https://doi.org/10.1007/BF02229160
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DOI: https://doi.org/10.1007/BF02229160