Introduction: Hyoscine butyl bromide, better known as buscapine, widely used in medicine, is a muscarinic antagonist that shares properties with atropine. Objective: To review the pharmacology, mechanism of action, systemic effects, interactions, toxicity, and side effects of hyoscine butyl bromide to understand why it may be useful in the management of perioperative bradycardia. Materials and Methods: A bibliographic review was carried out in the main databases with the search of the scientific literature according to the key words defined. Conclusions: Butyl bromide hyoscine may be an option in the management of intraoperative bradyarrhythmias with a rapid onset of action, more controlled increased heart rate and low penetration to the central nervous system.
Adrenal insufficiency is a deficiency in the secretion of steroid hormones, mainly glucocorticoids from the adrenal gland. It can be classified in primary when the alteration occurs at the level of the adrenal gland; or secondary, due to a central defect that compromises corticotropin (ACTH) or corticotropin-releasing hormone (CRH) secretion. Adrenergic suppression and compromised response to stress characteristic of patients with adrenal deficiency constitute a potentially fatal clinical condition, especially in operating rooms, where it becomes a challenge for the entire surgical team, particularly the anesthesiologist, where is essential to carry out a comprehensive pre-anesthetic assessment, creating an anesthetic plan focused on correct adrenergic substitution, which is decisive in the patient's prognosis.
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