Presentation
Here we present a case of a 17-year-old boy with ulcerative colitis who presented with ballismus, torticollis, tongue thrusting, and oculogyric movements after colonoscopy under general anesthesia with propofol. [ncbi.nlm.nih.gov]
In this section, the impact of the study drugs on ERP measures of recollection, which occur in the parietal region 400–600 ms after picture presentation, is presented. [dx.doi.org]
Entire Body System
- Intravenous Administration
An endotracheal intubation was performed after induction with intravenous administration of muscle relaxant. Total intravenous anesthesia via propofol drip infusion (4-7 mg/kg/h) was used during the scanning. [ncbi.nlm.nih.gov]
To prevent that pain, anesthesiologists will often an inject a local anesthetic like lidocaine before the intravenous administration of propofol, she said. [health.harvard.edu]
The main purpose of this study was to compare patients’ subjective tolerance, recovery of brain function and safety of use after intravenous administration of propofol and midazolam by bolus during FB, using the bispectral index (BIS) as an objective [erj.ersjournals.com]
- Intravenous Drugs
Propofol is an intravenous drug used commonly for the induction and maintenance of anesthesia. It is also used for sedation for non-surgical procedures and for patient intensive care. [thesun.co.uk]
Case 2 A 36 year old man with history of psychotic illness attributed to longstanding alcoholic and intravenous drug misuse came to the emergency room with right leg cellulitis. [emj.bmj.com]
It is well known that patients with advanced oncological and haematological disease, including solid organ and bone marrow transplantation, intravenous drug users and HIV patients, have a higher incidence of complications during bronchoscopy [ 23 ]. [erj.ersjournals.com]
- Congestive Heart Failure
Comorbidities including chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, cerebrovascular disease, renal failure, liver disease, malignant solid tumour, haematological malignancy, rheumatic disease, diabetes mellitus [erj.ersjournals.com]
- Asymptomatic
He was successfully treated with bag-mask ventilation and dexacort and was discharged asymptomatic after few hours of observation. [frontiersin.org]
Cardiovascular
- Hypertension
No patient showed hypertension during the endoscopic therapy procedure. Bradycardia occurred in one patient (0.5%, 1/182), and hypoxia occurred in one patient (0.5%, 1/182). All complications were easily treated with no adverse sequelae. [ncbi.nlm.nih.gov]
Anesthetics have been introduced into ECT sessions to alleviate ECT-inducing discomfort sensation, tachycardia, arrhythmia, hypertension, and anxiety. [clinicaltrials.gov]
Clevidipine (Cleviprex ® ) is an IV calcium-channel blocker used to treat peri-operative hypertension as well as acute, severe hypertension (See Figure 1). Both are milky white solutions that are infused intravenously. [apsf.org]
Side effects of propofol include pain at the injection site, hypotension, hypertension, nausea, cough, tingling sensation, and itching Rare side effects include arrhythmia, convulsion, and cardiac arrest. [britannica.com]
- Heart Disease
Valve Regurgitation 1 4CompletedTreatment Coronary Artery Disease / Off Pump Coronary Artery Bypass Surgery 1 4CompletedTreatment Coronary Artery Disease / Valvular Heart Disease 1 4CompletedTreatment Critical Illness 1 4CompletedTreatment Deep Sedation [drugbank.ca]
Heart disease: If you have heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed [medbroadcast.com]
Musculoskeletal
- Myalgia
The majority of patients experienced self‐limited fever (89.2%), chills (73.0%), or myalgia (63.5%). Blood samples from five patients were collected for culture; no organisms grew. [dx.doi.org]
[…] headache / Early / 0-1.0 insomnia / Early / 0-1.0 drowsiness / Early / 0-1.0 shivering / Rapid / 0-1.0 agitation / Early / 0-1.0 urticaria / Rapid / 0-1.0 diaphoresis / Early / 0-1.0 flushing / Rapid / 0-1.0 chills / Rapid / 0-1.0 fever / Early / 0-1.0 myalgia [pdr.net]
Neurologic
- Seizure
One risk to the fetus is cardiac deceleration during the grand mal seizure. We present a case of a young woman in her second trimester of pregnancy with bipolar depression. [ncbi.nlm.nih.gov]
Thus, dosage of electrical stimulus may be increased to achieve ideal seizure quality in this setting, which also leads to higher risk of subsequent cognitive impairment. [clinicaltrials.gov]
These movements may include: dystonia chorea athetosis twitches opisthotonus Abnormal movements may mimic tonic and clonic movements during seizures, especially during the postoperative period. 76 In several cases, cortical epilepsy was activated during [epilepsy.com]
- Giddiness
It reduces inhibition, people get giddy, and whatever thoughts they have on their mind, they tell you. It can also cause hallucinations, because whatever is in a person's head is more likely to be seen. [scientificamerican.com]
- Somnolence
Apomorphine: (Moderate) Apomorphine causes significant somnolence. Concomitant administration of apomorphine and CNS depressants could result in additive depressant effects. [pdr.net]
Workup
Serum
- Triglycerides Elevated
He did not have any elevation of triglycerides and on propofol re-challenge, had recurrence of pancreatitis with the absence of triglyceride elevation. [ncbi.nlm.nih.gov]
Treatment
For the treatment of refractory status epilepticus†. [pdr.net]
A total of 22 metabolites were detected varied after propofol posthypoxia treatment. [ncbi.nlm.nih.gov]
Prognosis
As Joan Rivers ’ prognosis grows more dire each day, RadarOnline.com has learned that medical investigators are growing ever closer to uncovering the real reason the healthy 81-year-old was sent spiraling into a coma after a standard medical procedure [radaronline.com]
Priapism: a three-phase concept of management according to aetiology and prognosis. Br J Urol 1986 ;58: 113 – 8. Google Scholar | Crossref | Medline 5. van Arsdalen, KN, Chen, JW, Smith, MJ. Penile erections complicating transurethral surgery. [dx.doi.org]
In Diamond’s case, it would be helpful to have an interdisciplinary team meeting to clarify her prognosis and goals of care. [pediatrics.aappublications.org]
Etiology
CONCLUSION: We report a case of hypertriglyceridemia independent propofol induced pancreatitis possibly related to an idiosyncratic reaction and propose that this drug to be reassigned as a class Ia drug as an etiologic factor for acute pancreatitis. [ncbi.nlm.nih.gov]
Our limited knowledge on the etiology and pathophysiology of PRIS preclude effectively preventing its occurrence. High doses and long-term infusion are the main risk factors. [n.neurology.org]
Evaluation of the patient's medical history and drug profile allowed us to exclude possible etiologies of green urine, such as methylene blue, indigo, biliverdin, medicines or infection. [omicsonline.org]
At five of seven hospitals, an etiologic agent was isolated from the case patients ( Table 4 ). [nejm.org]
Epidemiology
Chen MD Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg, PA, USA Search [dx.doi.org]
In: Program and abstracts of the 2nd Annual Meeting of the Society for Hospital Epidemiology of America, Baltimore, April 12–14, 1992. West Deptford, N.J.: Society of Hospital Epidemiology of America, 1992. abstract. 41. [nejm.org]
The epidemiology of propofol abuse is unfamiliar to most of the anesthesia providers. Propofol generally has not been listed as a controlled substance. [journals.lww.com]
Solís Herruzo Department of Gastroenterology. 1 Department of Epidemiology. Hospital Unviersitario 12 de Octubre. [scielo.isciii.es]
Risk of bias and methodological appraisal practices in systematic reviews published in anaesthetic journals: a meta-epidemiological study. Anaesthesia. 2016;71:955–68. View Article Google Scholar Berning V, Laupheimer M, Nübling M, Heidegger T. [bmcanesthesiol.biomedcentral.com]
Pathophysiology
Her brain magnetic resonance imaging (MRI) and computed tomography (CT) scans reveal prominent bilateral brain lesions, matching with the proposed pathophysiologic mechanism of the syndrome. [ncbi.nlm.nih.gov]
Our limited knowledge on the etiology and pathophysiology of PRIS preclude effectively preventing its occurrence. High doses and long-term infusion are the main risk factors. [n.neurology.org]
The propofol infusion “syndrome” in intensive care unit: From pathophysiology to prophylaxis and treatment. Acta Anaesthesiol Belg. 2008;59(2):79–86. 25. Jorens PG, Van den Eynden GG. [revistas.javeriana.edu.co]
Aetiology and pathophysiology PRIS is thought to be secondary to an imbalance between energy demand and utilization caused by impairment of mitochondrial oxidative phosphorylation and free fatty acid utilization, ultimately leading to lactic acidosis [academic.oup.com]
Prevention
Atlanta, GA, USA Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA Centers for Disease Control and Prevention, 1600 Clifton Rd MS‐A35, Atlanta, GA 30333, USA. [dx.doi.org]
BACKGROUND: Preconditioning is one of the most powerful mechanisms preventing the myocardial ischemic damage that occurs during coronary artery bypass grafting. [ncbi.nlm.nih.gov]
[…] substance that can react readily with, and thereby eliminate, radicals. intravenous anaesthetic sedative A central nervous system depressant used to induce drowsiness or sleep or to reduce psychological excitement or anxiety. antiemetic A drug used to prevent [ebi.ac.uk]