Sudden occurence of hypotension and bradycardia during greenlight laser transurethral resection of prostate: case report of two cases

Guo, Zheng; Liu, Jingjie

doi:10.1186/s12871-016-0234-x

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…They also assumed that a prostate procedure may induce a vagal reflex because the pelvic splanchnic nerves, which are parasympathetic nerves, run close to the apex of the prostate at the level of the membranous urethra. 17) The prostate was not manipulated directly in this patient, lower urinary tract manipulation with endoscopic instruments during ureteral stents placement might have affected pelvic splanchnic nerves around the prostate. So, the transurethral procedure might have increased parasympathetic activity and induced a cardiac vagal reflex.…”

Section: Discussionmentioning

confidence: 93%

Asystole During Administration of Dexmedetomidine with Spinal Anesthesia: A Case Report

Amano

Tateda

Inoue

2018

J St. Marianna Univ

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Dexmedetomidine is a useful sedative drug that does not cause severe respiratory depression but sometimes causes hypotension or bradycardia. We encountered a case in which asystole occurred during transurethral lithotomy (TUL) that was performed under spinal anesthesia with administration of dexmedetomidine. The patient was a 73-year-old man whose medical history included radiation therapy for prostate cancer and TUL, which had been performed under spinal anesthesia without incident. Results of preoperative examination were unremarkable, and electrocardiography (ECG) showed sinus rhythm with heart rate of 74 bpm. Spinal anesthesia was administered with 3.4 mL of 0.5% hyperbaric bupivacaine, and upper level sensory loss was confirmed at T10. Ten minutes after injection of the bupivacaine, dexmedetomidine was administered for sedation at a loading dose of 3 μg/kg/h over 10 minutes; it was continued at 0.4 μg/kg/h. The patient's vital signs were stable, but because his SpO 2 on room air decreased to 93%, oxygen inhalation was started, and the dexmedetomidine was reduced to 0.2 μg/kg/h. Upon completion of the operation, 115 minutes after the bupivacaine injection, the patient groaned, and almost simultaneously, his heart rate decreased to 30 bpm and progressed to asystole. The dexmedetomidine infusion was stopped, and 0.5 mg of atropine was injected intravenously. Before chest compressions were started, sinus rhythm returned, and the patient regained consciousness. No ECG abnormalities were found. Upper level sensory block at T10 was reconfirmed. The patient was discharged the next day without complications. We reasoned that the asystole resulted as an adverse effect of the dexmedetomidine, from a vagal reflex, and from the spinal anesthesia. Our case illustrates both the importance of avoiding the administration of dexmedetomidine above the recommended dose during spinal anesthesia and the need for careful ECG monitoring and observation of hemodynamics in patients undergoing TUL.

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Section: Discussionmentioning

confidence: 93%

Asystole During Administration of Dexmedetomidine with Spinal Anesthesia: A Case Report

Amano

Tateda

Inoue

2018

J St. Marianna Univ

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“…For nickel-base super-alloy, Manonukul and Dunne [38] added the CPFEM concept to analyze the crack formation characteristic in LCF and HCF. For the same material, Guan et al [39] incorporated CPFEM and high-resolution digital image correlation technique to analyze the strain localization under fatigue. It is reported that for a wide range of parameters, the CPFEM can predict the material behavior very accurately.…”

Section: Crystal Plasticity Modelmentioning

confidence: 99%

Advances in Fatigue Prediction Techniques

Kumar¹,

Gaur²

2022

Advances in Fatigue and Fracture Testing and Modelling

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Fatigue is the prevalent mode of failure in engineering components made from metals. It occurs when the component is undergone fluctuating stresses. It leads to failure in metal structures because of damage accumulation. Therefore fatigue analysis of these structures is vital to ensure service reliability during the real operation. Among various simulation tools available to determine the fatigue life and mechanical behavior of metals and metallic components, the Crystal Plasticity Finite Element Method (CPFEM) has gained wide attention to analyze the microstructural attributes. Owing to the versatility of CPFEM in analyzing the fatigue properties of various metals and alloys, this chapter is aimed to examine and document the state-of-the-art research outcomes linked to fatigue behavior using CPFEM tool. The CPFEM is expected to accelerate the research progress to discover novel metals and alloys with better fatigue properties. For structural welds, estimating fatigue life depends on the material characteristics, object geometry, and applied loads. An in-depth analysis of stress concentrations across the affected areas of welds is vital for calculating fatigue response.

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Sudden occurence of hypotension and bradycardia during greenlight laser transurethral resection of prostate: case report of two cases

Cited by 2 publications

References 16 publications

Asystole During Administration of Dexmedetomidine with Spinal Anesthesia: A Case Report

Asystole During Administration of Dexmedetomidine with Spinal Anesthesia: A Case Report

Advances in Fatigue Prediction Techniques

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