Arrêt cardiocirculatorie lors d'une anesthésie associant propofol et fentanyl

Dandoy, M; Poisson, Franck; Lampl, E

doi:10.1016/s0750-7658(05)80957-8

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…An abrupt, unpredictable decrease, or a progressive slowing of the heart rate, and sudden cardiac arrests were reported. Associated complications involved [19], [63], [72][73][74] tonic-clonic movements, 64 arrhythmia of unknown type, 36 junctional rhythm, 63 64 supraventricular bradycardia, 65 recurrence of asystole, 67 70 and intermittent episodes of heart block. 70 Treatment of bradycardic events consisted in most cases of i.v.…”

Section: Qualitative Analysis Of Published Reportsmentioning

confidence: 99%

“…7 51 52 66 Several bradycardic episodes resolved spontaneously. The longest duration of asystole in surviving patients was 45 s. 64 Several factors, alone or in combination, were coincident with bradycardic complications during propofol anaesthesia and were therefore suspected in the original reports to be jointly responsible for the negative outcome: surgical stimulation, 9 36 lack of surgical stimulation, 63 67 extradural anaesthesia, 51 previous syncope, 7 64 67 preoperative conduction abnormalities, 57 71 fentanyl, 8 63 65 suxamethonium, 35 62 65 atracurium, 8 beta-blocker, 61 70 ornipressin, 8 neostigmine, 70 any factors or drugs potentiating vagal stimulation, 19 68-70 72 73 absence of vagal stimulation, 63 too light anaesthesia, 76 insufficient prophylactic dose of atropine 48 50 and an individual susceptibility to propofol. 63 65 Most authors concluded that a prophylactic anticholinergic may be indicated in the presence of any risk factor if propofol is to be used.…”

Section: Qualitative Analysis Of Published Reportsmentioning

confidence: 99%

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Propofol and bradycardia: causation, frequency and severity

Tramèr

Moore

McQuay

1997

British Journal of Anaesthesia

201

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As part of the development of a model for the study of adverse events, we have investigated the risk of bradycardia with propofol. A systematic search for any type of report, published and unpublished, was made to review the evidence that propofol increases the risk of bradycardia, asystole and death from bradycardic events. Quantitative and qualitative analyses of data with different strengths of evidence were performed. Sixty-five published and 187 spontaneous reports to drug monitoring centres described with different strength of evidence a biological basis for propofol-induced bradycardia, 1444 bradycardias, 86 asystoles and 24 deaths. In controlled clinical trials, propofol significantly increased the risk of bradycardia compared with other anaesthetics (number-needed-to-harm 11.3 (95% confidence interval 7.7-21)). In paediatric strabismus surgery the number-needed-to-harm was 4.1 (3-6.7). One of 660 patients undergoing propofol anaesthesia had an asystole. The risk of bradycardia-related death during propofol anaesthesia was estimated to be 1.4 in 100,000. Data from the phase IV study of propofol did not agree with data from controlled studies. Propofol carries a finite risk for brady-cardia with potential for major harm. Study of adverse events should be made with systematically searched data and, in contrast with study of efficacy, not restricted to randomized, controlled trials.

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Section: Qualitative Analysis Of Published Reportsmentioning

confidence: 99%

Section: Qualitative Analysis Of Published Reportsmentioning

confidence: 99%

Propofol and bradycardia: causation, frequency and severity

Tramèr

Moore

McQuay

1997

British Journal of Anaesthesia

201

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“…Propofol is known to cause a reduction in sympathetic activity ( 1, 2) and often slightly slows HR, together with a decrease in BP. The incidence of bradycardia is low ( 3), but AV blocks of various degrees have been described in adults after propofol use, including complete heart block even leading to asystole ( 4–9). In all those observations other vagal factors were associated: vagal tendency, peritoneal manipulation or vagomimetic drugs such as fentanyl, suxamethonium or anticholinesteratic agents.…”

Section: Discussionmentioning

confidence: 99%

Heart block following propofol in a child

Sochala

Deenen

Villé

et al. 1999

Pediatric Anesthesia

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We present the case of a nine-year-old boy afflicted with Ondine's curse, who developed complete atrioventricular heart block after a single bolus of propofol for induction of anaesthesia for strabismus surgery. Ondine's curse, the other name for congenital central hypoventilation syndrome, is characterized by a generalized disorder of autonomic function. Propofol has no effect on the normal atrioventricular conduction system in humans but it reduces sympathetic activity and can highly potentiate other vagal stimulation factors. Heart block has been documented after propofol bolus use in adults but, to our knowledge, not in children. It would appear that propofol is not a good choice for anaesthesia in congenital central hypoventilation syndrome.

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Asystolie lors d'une anesthésie avec propofol

Bricchi

Gemma

1991

Annales Françaises d'Anesthésie et de Réanimation

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Arrêt cardiocirculatorie lors d'une anesthésie associant propofol et fentanyl

Cited by 5 publications

References 2 publications

Propofol and bradycardia: causation, frequency and severity

Propofol and bradycardia: causation, frequency and severity

Heart block following propofol in a child

Asystolie lors d'une anesthésie avec propofol

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