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Propofol infusion syndrome

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https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#1
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27779344/dexmedetomidine-use-in-patients-undergoing-electrophysiological-study-for-supraventricular-tachyarrhythmias
#2
Christopher F Tirotta, Tuan Nguyen, Steven Fishberger, Evelio Velis, Melissa Olen, Lourdes Lam, Danielle R Madril, Jessica Hughes, Richard G Lagueruela
BACKGROUND: Dexmedetomidine is a selective alpha-2 adrenergic agonist with sedative, analgesic, and anxiolytic properties. Dexmedetomidine has not been approved for use in pediatrics. Dexmedetomidine has been reported to depress sinus node and atrioventricular nodal function in pediatric patients; it has been suggested that the use of dexmedetomidine may not be desirable during electrophysiological studies. AIM: We hypothesize that the use of dexmedetomidine does not inhibit the induction of supraventricular tachyarrhythmias (SVT) during electrophysiological studies and does not inhibit the ablation of such arrhythmias...
October 25, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27738550/propofol-related-infusion-syndrome-in-the-peripartum-period
#3
Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27631259/opioid-free-general-anesthesia-in-patient-with-steinert-syndrome-myotonic-dystrophy-case-report
#4
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27588242/in-vivo-study-of-hepatic-oxidative-stress-and-mitochondrial-function-in-rabbits-with-severe-hypotension-after-propofol-prolonged-infusion
#5
Sónia Campos, Luís Félix, Carlos Venâncio, Maria de Lurdes Pinto, Francisco Peixoto, Paula Guedes de Pinho, Luís Antunes
In humans, prolonged sedations with propofol or using high doses have been associated with propofol infusion syndrome. The main objective of this study was to evaluate the effects of prolonged high-dose administration of a specific propofol emulsion (Propofol Lipuro) and an improved lipid formulation (SMOFlipid) in liver mitochondrial bioenergetics and oxidative stress of rabbits, comparatively to a saline control. Twenty-one male New Zealand white rabbits were randomly allocated in three groups that were continuously treated for 20 h...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27554227/effect-of-continuous-paravertebral-dexmedetomidine-administration-on-intraoperative-anesthetic-drug-requirement-and-post-thoracotomy-pain-syndrome-after-thoracotomy-a-randomized-controlled-trial
#6
Vikas Dutta, Bhupesh Kumar, Aveek Jayant, Anand K Mishra
OBJECTIVES: To assess the effect of paravertebral administration of dexmedetomidine as an adjuvant to local anesthetic on the intraoperative anesthetic drug requirement and incidence of post-thoracotomy pain syndrome. DESIGN: Prospective, randomized, controlled, double-blind trial. SETTING: Single university hospital. PARTICIPANTS: The study comprised 30 patients who underwent elective thoracotomy and were assigned randomly to either the Ropin or Dexem group (n = 15 each)...
May 31, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27493812/propofol-infusion-syndrome-in-refractory-status-epilepticus-a-case-report-and-topical-review
#7
Akil Walli, Troels Dirch Poulsen, Mette Dam, Jens Børglum
Propofol infusion syndrome (PRIS) is a fatal complication when doses of propofol administration exceed 4 mg/kg/h for more than 48 hours. Propofol overdosage is not uncommon in patients with refractory status epilepticus (RSE). We describe a case of refractory status epilepticus complicated by propofol infusion syndrome and collect from 5 databases all reports of refractory status epilepticus cases that were treated by propofol and developed the syndrome and outline whether refractory status epilepticus treatment with propofol is standardized according to international recommendations, compare it with alternative medications, and discuss how this syndrome can be treated and prevented...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27488955/propofol-is-mitochondrion-toxic-and-may-unmask-a-mitochondrial-disorder
#8
Josef Finsterer, Marlies Frank
There are indications that preexisting mitochondrial disorders or beta-oxidation defects predispose for propofol infusion syndrome. This review aimed at investigating if propofol infusion syndrome occurs exclusively in patients with mitochondrial disorder and if propofol can unmask a mitochondrial disorder. Propofol infusion syndrome has been reported in genetically confirmed mitochondrial disorder patients. In addition, muscle biopsy of patients with propofol infusion syndrome revealed complex IV or complex II deficiency...
November 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27340909/the-effect-of-concomitant-sirolimus-and-propofol-therapy-on-triglyceride-concentrations-in-critically-ill-patients
#9
Kevin M Dube, Paul M Szumita, Megan A Rocchio, Po-Shun Lee, Kevin E Anger
BACKGROUND: Sirolimus and propofol are both independently associated with the development of hypertriglyceridemia (HTG) during therapy. To date, there are no published reports describing synergistic or additive drug interaction resulting in HTG with concomitant use of these medications. STUDY QUESTION: To identify the occurrence of HTG in patients receiving concomitant sirolimus and propofol infusion therapy. METHODS: Adult patients receiving sirolimus and a continuous propofol infusion for at least 12 hours from January 2005 to August 2009 were retrospectively evaluated...
June 23, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/27319100/-general-anesthesia-using-remifentanil-for-cesarean-section-in-a-parturient-with-marfan-syndrome-associated-with-heart-failure-due-to-severe-mitral-regurgitation
#10
Masahide Fujita, Tsuyoshi Satsumae, Makoto Tanaka
A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change...
May 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27252070/pharmaceutical-approach-for-the-diagnosis-and-treatment-of-malignant-syndrome-a-case-study
#11
Keisuke Kameda, Kazuhiro Watarai, Kenji Takahashi, Tomohisa Shoko, Masayoshi Koinuma, Goro Ikushima
Since 2012, Matsudo City Hospital has increased the number of pharmacists stationed in the ward on weekday mornings at the emergency care center, the intensive care unit (ICU) and the high care unit (HCU). Multidisciplinary joint meetings and joint conferences are conducted in the emergency care center, and patient and drug information is shared. A 20-year-old man was transferred to our hospital after a traffic accident. He was diagnosed with subarachnoid hemorrhage and brain contusion. He exhibited violent movement and intense restlessness...
2016: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/27116413/dexmedetomidine-as-an-adjunct-for-sedation-in-patients-with-traumatic-brain-injury
#12
Mehrnaz Pajoumand, Joseph A Kufera, Brandon W Bonds, Sandeep Devabhakthuni, Sharon Boswell, Kathleen Hesselton, Thomas M Scalea, Deborah M Stein
BACKGROUND: In patients with traumatic brain injury (TBI), optimizing sedation is challenging because maintaining a clinical examination is important in being able to detect neurological deterioration. Propofol (PROP) is frequently used as a sedative in TBI since it has been shown to reduce the cerebral metabolic rate, but it may lead to PROP-related infusion syndrome and hemodynamic compromise. Dexmedetomidine (DEX) is a sedative that produces minimal respiratory depression with opioid-sparing effects...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26804714/-postoperative-visual-loss-due-to-conversion-disorder-after-spine-surgery-a-case-report
#13
Dailson Mamede Bezerra, Eglantine Mamede Bezerra, Antonio Jorge Silva Junior, Marco Aurélio Soares Amorim, Denismar Borges de Miranda
BACKGROUND AND OBJECTIVE: Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. CASE REPORT: A male patient, 39 years old, 71kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4-L5 and L5-S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8...
January 21, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26799430/outcomes-of-patients-with-alcohol-withdrawal-syndrome-treated-with-high-dose-sedatives-and-deferred-intubation
#14
Robert Stewart, Ricardo Perez, Bogdan Musial, Carrie Lukens, Yaw Amoateng Adjepong, Constantine A Manthous
RATIONALE: High doses of sedating drugs are often used to manage critically ill patients with alcohol withdrawal syndrome. OBJECTIVES: To describe outcomes and risks for pneumonia and endotracheal intubation in patients with alcohol withdrawal syndrome treated with high-dose intravenous sedatives and deferred endotracheal intubation. METHODS: Observational cohort study of consecutive patients treated in the intensive care unit (ICU) of a university-affiliated, community hospital for alcohol withdrawal syndrome, where patients were not routinely intubated to receive high-dose or continuously infused sedating medications...
February 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/26602285/perioperative-considerations-in-adult-mitochondrial-disease-a-case-series-and-a-review-of-111-cases
#15
REVIEW
Yuri Miyamoto, Tetsuya Miyashita, Shunsuke Takaki, Takahisa Goto
Mitochondrial disease has been uncommon conditions, still results in death during childhood in many cases. The ideal anesthetic pharmacological management strategy for adult patients with mitochondrial disease is currently unclear. In this study, we presented features of the anesthesia methods employed and the perioperative complications of patients in our institution and in previously published case reports. We report the use of general anesthesia 7 times in 6 adult patients with mitochondrial disease during 2004-2014...
January 2016: Mitochondrion
https://www.readbyqxmd.com/read/26558513/propofol-infusion-syndrome-a-structured-review-of-experimental-studies-and-153-published-case-reports
#16
REVIEW
Adéla Krajčová, Petr Waldauf, Michal Anděl, František Duška
INTRODUCTION: Propofol infusion syndrome (PRIS) is a rare, but potentially lethal adverse effect of a commonly used drug. We aimed to review and correlate experimental and clinical data about this syndrome. METHODS: We searched for all case reports published between 1990 and 2014 and for all experimental studies on PRIS pathophysiology. We analysed the relationship between signs of PRIS and the rate and duration of propofol infusion causing PRIS. By multivariate logistic regression we looked at the risk factors for mortality...
November 12, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26354738/pris-may-be-diagnosed-before-icu-period-for-patients-undergoing-cardiopulmonary-bypass
#17
Türker Şahin
There are many published articles on the clinical manifestations of propofol-related infusion syndrome (PRIS), but they are not the same in each case.(1)Moreover, PRIS is only encountered infrequently and, therefore, it may create a diagnostic challenge. Nearly all of the published articles on PRIS are related to the use of long-term (> 48 hour) propofol infusion with a dose range of at least 4-5 mg/kg/h. In this case, not only a short duration, but also a low-dose propofol administration seems to induce PRIS...
May 2016: Perfusion
https://www.readbyqxmd.com/read/26341149/extracorporeal-membrane-oxygenation-and-sustained-low-efficiency-diafiltration-successfully-resuscitated-propofol-infusion-syndrome-during-refractory-status-epilepticus
#18
LETTER
Yi-Ting Fang, Vin-Cent Wu, Sung-Chun Tang, Huei-Ming Yeh
No abstract text is available yet for this article.
November 2015: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/26308172/propofol-induced-rhabdomyolysis-a-case-report
#19
Zhi-Bin Zhou, Xiao-Yu Yang, Xue Zhou, Li-Jun Niu, Liang-Can Xiao, Wen-Qi Huang, Xia Feng
OBJECTIVE: To report a case of propofol-induced rhabdomyolysis. In this case, widespread myolysis was detected after induction of anesthesia. CASE SUMMARY: A 54-year-old female patient was scheduled for a hysterectomy. Beginning shortly after the induction of anesthesia with propofol, several episodes of ventricular fibrillation occurred. Despite intensive care, the patient failed to recover. During most episodes of ventricular fibrillation, marked hyperthermia or hyperkalemia were not observed...
October 2015: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/26256988/pharmacodynamic-estimate-of-propofol-induced-sedation-and-airway-obstruction-effects-in-obstructive-sleep-apnea-hypopnea-syndrome
#20
Bon-Nyeo Koo, Seokyung Shin, So Yeon Kim, Young Ran Kang, Kyu Hee Jeong, Dong Woo Han
PURPOSE: Sedatives must be carefully titrated for patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) as oversedation may lead to disastrous respiratory outcomes. This study aimed to investigate the relations between the effect-site concentration (Ce) of propofol and sedation and airway obstruction levels in patients with OSAHS. MATERIALS AND METHODS: In 25 patients with OSAHS, sedation was induced by 2% propofol using target-controlled infusion. Sedation and airway obstruction levels were assessed using the Observer's Assessment of Alertness/Sedation Scale and a four-category scale, respectively...
September 2015: Yonsei Medical Journal
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