Neurologic Changes During Awakening from Anesthesia

Rosenberg, Henry; Clofine, Richard; Bialik, Ora

doi:10.1097/00000542-198102000-00005

Cited by 73 publications

(21 citation statements)

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“…This theory is endorsed by evidence that the incidence of shivering is inversely related to the level of consciousness following anaesthesia [8]. However, a subsequent study did not confirm this finding [5] and we failed to find any correlation between postoperative sedation score and shivering in children.…”

Section: Discussionmentioning

confidence: 55%

Postanaesthetic shivering in children

et al. 1996

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SummaryThis study was designed to assess the incidence, severity and possible aetiological factors ofpostanaesthetic shivering in children. Three hundred and seventy-six children undergoing general anaesthesia were enrolled in the study. Tympanic membrane temperatures were recorded pre-operalively and every 15 min postoperatively in the recovery room until discharge to the ward.Also recorded were all anaesthetic data including,puid administration, methods of temperature preservation used, sedation scores und shivering (using a four-point scale). The overall incidence of shivering was 14.4%. Multiple regression anulysis identified three ,factors thut were significantly related to shivering: age, the administration of atropine and peri-operative temperature changes. Children who shivered rewarmed ,faster in the recovery room.

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Section: Discussionmentioning

confidence: 55%

Postanaesthetic shivering in children

et al. 1996

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“…The Babinski response has also been observed as a normal and temporary phenomenon in other situations, such as in the newborn where its gradual disappearance parallels myelinization of the pyramidal tracts (9,11). This response is also found normally during recovery from general anesthesia, which is thought to inhibit supraspinal control of the reflex mechanism (12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 94%

Relationship of Periodic Movements in Sleep (Nocturnal Myoclonus) and the Babinski Sign

Smith¹

1985

Sleep

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Summary: To obtain a comprehensive clinical description of periodic movements in sleep, the first 11 videotaped movements of nine patients were studied. These leg movements were characterized by active dorsiflexion of the ankle (91%), dorsiflexion and fanning of the small toes (82%), and dorsiflexion of the great toe (72%). Partial flexion of the knee and hip occurred in 28%. Simultaneous dorsiflexion of the ankle and small toe was almost always the initial change, either preceding or occurring simultaneously with extension of the great toe. Knee and hip flexion almost always followed foot movements. Tonic and/or clonic movements, usually about the ankle, occurred in 75%; plantar flexion of the ankle occurred in 21% at the end of a leg movement. Periodic movements in sleep were thus characterized on detailed videographic analysis by movements similar to the Babinski response. Since both the normally occurring nocturnal Babinski response and periodic movements in sleep are also almost entirely NREM related, the author proposes that periodic movements in sleep are due to the NREM loss of supraspinal inhibitory influences on the pyramidal tract and that the characteristic foot and leg movements are Babinski-type responses secondary to this.

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“…The subjects of Rosenberg and colleagues' investigation were all normothermic. 4 McCulloch 5 measured, but did not report axillary temperature, and Hoppenfeld et al 1 did not report core temperature. Shivering thermogenesis occurs in almost all hypothermic individuals after anesthesia but thermoregulation is only part of the etiology of postanesthetic clonus.…”

Section: Me Et Th Ho Od Ds Smentioning

confidence: 98%

The ankle clonus test is not a clinically useful measure of spinal cord integrity in children

Ewen

Cox

Davies

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Bilateral flexion-induced ankle clonus has been proposed as a test of spinal cord integrity during anesthesia for scoliosis surgery. The purpose of this study was to establish the reliability of this test in normal children emerging from volatile anesthesia. A secondary objective was to determine if there was a difference in the validity of this test with either sevoflurane or isoflurane anesthesia. M Me et th ho od ds s: :In a randomized, prospective blinded clinical trial, 32 healthy children aged three to 13 yr, were randomized to receive either isoflurane (Group I, n = 15) or sevoflurane (Group S, n = 17) for maintenance of anesthesia during dental restorative surgery. During emergence, an observer, blinded to group allocation, recorded ankle clonus scores (number of beats to a maximum of 5 on each side) at 60-sec intervals until tracheal extubation. End-tidal anesthetic concentration was measured contemporaneously.

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Neurologic Changes During Awakening from Anesthesia

Cited by 73 publications

References 0 publications

Postanaesthetic shivering in children

Postanaesthetic shivering in children

Relationship of Periodic Movements in Sleep (Nocturnal Myoclonus) and the Babinski Sign

The ankle clonus test is not a clinically useful measure of spinal cord integrity in children

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