Postoperative hypotension from topical use of 2% nitroglycerin ointment after a total knee replacement procedure

Siddiqi, Munawar; Marco, Alan P.; Gorp, Cornel V.

doi:10.1016/j.jclinane.2003.05.003

Cited by 4 publications

(3 citation statements)

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“…Common side effects of NTG ointment application are headache, dizziness, and hypotension 10 11 12 13 14 15 . In our study, no hypotension was reported in either group.…”

Section: Resultsmentioning

confidence: 99%

“…Many studies have proved that even low doses of NTG can cause frequent side effects including hypotension, flushing, and dizziness, suggesting that NTG is not well tolerated by some patients 10 11 12 13 14 15 . Dalsgaard-Nielsen 25 described a topical percutaneous NTG test, in which migraine attacks were provoked by an NTG ointment that was applied to the forehead and the temporal region.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, NTG can cause side effects. Several studies have reported complications such as headache, dizziness, and hypotension, which can make patients stop using NTG ointment 10 11 12 13 14 15 . Moreover, these side effects are dose-dependent.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Low-Dose Nitroglycerin Ointment on Skin Flap Necrosis in Breast Reconstruction after Skin-Sparing or Nipple-Sparing Mastectomy

et al. 2017

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BackgroundSkin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy.MethodsA total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups.ResultsSkin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio=7.81; 95% confidence interval, 1.38 to 44.23; P=0.02).ConclusionsLow-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.

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“…Common side effects of NTG ointment application are headache, dizziness, and hypotension 10 11 12 13 14 15 . In our study, no hypotension was reported in either group.…”

Section: Resultsmentioning

confidence: 99%