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Adverse effect of intraoperative phenylephrine 10%: case report
1Department of Ophthalmology, Faculty of Medicine, University of Malaya, Malaysia.
The British Journal of Ophthalmology
|June 1, 1989
Summary
Phenylephrine overdose can cause severe hypertension, cardiac arrhythmia, and myocardial infarction. Caution is advised when using phenylephrine drops during surgery, particularly for elderly patients or those with cardiovascular disease.
Area of Science:
- Cardiology
- Pharmacology
- Anesthesiology
Background:
- Phenylephrine is a sympathomimetic amine commonly used as a nasal decongestant and vasopressor.
- Ophthalmic and nasal formulations can lead to unintended systemic absorption.
Observation:
- A patient developed severe acute hypertension, cardiac arrhythmia, and myocardial infarction following the use of phenylephrine eye drops during surgery.
- The surgical setting may facilitate enhanced systemic absorption of the drug.
Findings:
- The patient's cardiovascular events were likely a direct consequence of phenylephrine overdose.
- Systemic absorption of phenylephrine during surgical procedures can lead to significant adverse effects.
Implications:
- Clinicians should exercise caution when administering phenylephrine, especially during surgical procedures.
- Particular vigilance is warranted in elderly patients and individuals with pre-existing cardiovascular conditions to prevent phenylephrine-induced toxicity.