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Trimetaphan may cause coronary artery spasm
1Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.
European Journal of Anaesthesiology
|September 1, 1995
Summary
This case report details a potential adverse reaction to trimetaphan, an antihypertensive drug, during surgery. The patient experienced cardiac events suggestive of coronary artery spasm, which resolved after drug withdrawal and treatment.
Area of Science:
- Cardiology
- Anesthesiology
- Pharmacology
Background:
- A 55-year-old male underwent surgery for a meningioma.
- Anesthesia was maintained with nitrous oxide and oxygen.
- Initial blood pressure was 114/70 mmHg, with a pulse rate of 60 bpm.
Observation:
- Intravenous trimetaphan was administered due to a rise in blood pressure during scalp incision.
- Following trimetaphan infusion, the patient developed premature ventricular contractions and ST-segment elevation.
- These cardiac events resolved after discontinuing trimetaphan and administering lignocaine and glyceryl trinitrate.
Findings:
- The observed cardiac events were temporally associated with trimetaphan administration.
- ST-segment changes normalized following glyceryl trinitrate infusion.
- Post-operative tests ruled out myocardial infarction.
Implications:
- This case suggests a possible link between trimetaphan and coronary artery spasm.
- Careful monitoring for cardiac adverse effects is warranted during trimetaphan use.
- Further investigation may be needed to elucidate the mechanism of trimetaphan-induced cardiac events.