Phenytoin is an anticonvulsant which is also a Class IB antiarrhythmic. Its common adverse drug reactions (ADRs) include gastrointestinal symptoms, psychiatric disorders, gingival hyperplasia, and rash. Bradycardia and hypotension following intravenous (IV) phenytoin are rare ADRs. We report the case of a 62-year-old female with subarachnoid hemorrhage and right bundle branch block, who developed sinus bradycardia and hypotension on administration of IV phenytoin. This case report serves as a note for caution on patient selection for the administration of phenytoin and highlights the need for specific guidelines on the same.
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http://dx.doi.org/10.4103/ijp.IJP_254_17 | DOI Listing |
BMJ Open
January 2025
Department of Anesthesiology and Perioperative medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
Introduction: Propofol is a fast-acting intravenous anaesthetic widely used for sedation and anaesthesia in gastrointestinal endoscopy, bronchoscopy, and the induction/maintenance of general anaesthesia in outpatients and inpatients; however, propofol has several undesirable effects, including injection pain, which affects the physical and mental health of patients, and cardiopulmonary depression, characterised by hypotension, bradycardia and apnea, which commonly occur in clinical practice. Ciprofol (HSK3486) is a propofol analogue with good clinical safety, high potency and some advantages over propofol, including lower injection pain and haemodynamic depression in patients undergoing gastroscopy and colonoscopy. This study aims to compare the impact of equivalent effective doses of propofol and ciprofol on haemodynamic changes in patients undergoing bronchoscopy under general anaesthesia.
View Article and Find Full Text PDFFront Pharmacol
January 2025
Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
Purpose: The incidence of hemodynamic instability associated with dexmedetomidine (DEX) sedation has been reported to exceed 50%, with substantial inter-individual variability in response. Genetic factors have been suggested to contribute significantly to such variation. The aim of this study was to identify the clinical, pharmacokinetic, and genetic factors associated with DEX-induced hemodynamic instability in pediatric anesthesia patients.
View Article and Find Full Text PDFCureus
December 2024
Anaesthesia, Medway NHS Foundation Trust, Kent, GBR.
Laparoscopic cholecystectomy has become the gold standard for treating symptomatic cholelithiasis due to its minimally invasive nature and faster recovery times compared to traditional open surgery, but it is not without risks. A key component of this procedure is the creation of pneumoperitoneum. This is achieved by insufflating the abdomen with carbon dioxide (CO2).
View Article and Find Full Text PDFCureus
December 2024
Community Medicine, Autonomous State Medical College, Auraiya, IND.
Introduction: Laparoscopic cholecystectomy has evolved into a daycare procedure thanks to advancements in both surgical and anesthetic techniques. Regional anesthesia, specifically segmental thoracic spinal anesthesia (TSA), offers distinct benefits over general anesthesia, such as enhanced hemodynamic stability and quicker recovery, especially in high-risk patients. This study aims to compare the sensory and motor block characteristics, hemodynamic stability, and incidence of adverse effects between isobaric and hyperbaric 0.
View Article and Find Full Text PDFIntensive Crit Care Nurs
January 2025
School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region. Electronic address:
Objectives: This systematic review synthesized literature evidence and compared midazolam's risks and clinical outcomes with other sedatives in critically ill mechanically ventilated patients.
Methods: We included randomized controlled trials (RCTs) from databases of PubMed, Embase, Cochrane Library, Web of Science, and CINAHL without language restrictions. We used relative risk (RR) for binary outcomes and standardized mean difference (SMD) for continuous outcomes, with corresponding 95% confidence interval (CI).
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