Ephedrine
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Increased systolic BP and HR: case report A 60-year-old woman exhibited unexpectedly large increase in systolic BP and HR during treatment with ephedrine during treatment of decreased BP. The woman, who had stage 4 Parkinson’s disease with severe cardiac sympathetic nerve denervation, was scheduled for total hip joint replacement surgery. In the operating room, following an installation of standard monitors, she was administered with midazolam for sedation and spinal anaesthesia with bupivacaine was given. During the surgery propofol was also infused for sedation. For decreased BP, she was administered IV ephedrine 4mg. Additionally, she was receiving treatment with levodopa and pramipexole [pramipexole hydrochloride hydrate] concomitantly. Subsequently, an unexpectedly large increase in the systolic BP from 78mm Hg to 168mm Hg and HR from 52 to 84 beats per minute was noted [duration of treatment to reaction onset not stated]. This large increase in systolic BP and HR recurred, whenever ephedrine was administered [final outcome not stated]. Author comment: "Here, we present a case of ephedrineinduced increases in blood pressure and heart rate suspected to be due to denervation supersensitivity in a patient with parkinson’s disease (PD)." Kitaura A, et al. Ephedrine-induced increases in blood pressure and heart rate due to suspected cardiac sympathetic denervation supersensitivity in a patient with Parkinson's disease under spinal anesthesia. American Journal of Case Reports 20: 1104-1107, 26 Jul 2019. Available from: URL: http:// 803435484 doi.org/10.12659/AJCR.916188 - Japan
0114-9954/19/1780-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved
Reactions 23 Nov 2019 No. 1780
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