A Ramesh, G McFadyen
A Ramesh, G McFadyen. Propofol To Control Tremors. The Internet Journal of Anesthesiology. 2005 Volume 11 Number 1.
We would like to report the use of propofol for controlling tremors in a patient for cataract surgery under topical anaesthesia. Propofol has been found to have contrasting effects in movement disorders1. Propofol has been found to cause myoclonus and dyskinesia but it has also been found to have an opposite effect to suppress tremors in some studies. Anderson 1 et al report suppression of tremors for 8 hrs after propofol anaesthesia for thalamotomy. Fukuda2 et al report the disappearance of tremors under propofol anaesthesia for stereotactic surgery and reappearance with discontinuation of infusion.
We anaesthetised a 79 year old female for cataract surgery under topical anaesthesia. She had a past history of multiple strokes and residual tremors mainly involving her head and neck. She did not have any neurological deficits. Since she could not lie still because of tremors, we decided to use propofol for sedation. After attaching the routine monitors and gaining IV access, target controlled infusion of propofol was started at 2 microgram/ml. Tremors stopped on reaching the target. She was transferred to the theatre and the surgery was performed under topical anaesthesia with no complications. She had supplemental oxygen through out the procedure and was able to communicate to her through out. The target was reduced from 2 to 1.3 microgram/ml during the operation. The infusion of propofol was stopped on completing the surgery and the tremors reappeared immediately. With the successful use of propofol for suppressing tremors in our case, we feel that propofol can be used in suppressing tremors for inserting central or arterial lines and doing regional procedures.