Ephedrine‐induced erythrodermia: Clinical diagnostic procedure and cross‐sensitivity

Tanno, Luciana Kase; Fillard, Anouchka; Landry, Quentin; Ramdane, Chahinaze; Bourrain, Jean‐Luc; Demoly, Pascal; Chiriac, Anca Mirela

doi:10.1111/cod.12980

Cited by 7 publications

(11 citation statements)

References 18 publications

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“…Furthermore, the high percentage of pruritus, nausea, and vomiting in C group cases may be due to increased utilization of meperidine [ 26 ]. In addition, the research team recorded increased utilization of ephedrine in C group cases which might explain probability of systemic hypersensitivity reactions [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial for Prevention of Postspinal Anesthesia Shivering in Gynecological Surgeries: Mirtazapine vs. Dexamethasone

Esmat

Elsayed

El-Hariri

et al. 2022

Anesthesiology Research and Practice

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Background. The frequency of shivering regarding regional anesthesia is 55%. Newer effective and tolerable options for postspinal anesthesia shivering (PSAS) prophylaxis are necessary to improve patients’ quality of care. This research assessed the impact of preemptive mirtazapine versus preemptive dexamethasone to decrease frequency and severity of PSAS in gynecological procedures. Methods. 300 patients booked for gynecological procedures under spinal anesthesia (SA) were randomly apportioned into three groups (100 each) to get one preemptive dose of 30 mg mirtazapine tablet (M group), 8 mg dexamethasone diluted in 100 ml of saline infusion (D group) or placebo (C group) two hours before surgery. Incidence of clinically significant PSAS was the primary outcome. Core temperature, shivering score, hemodynamics changes, adverse events, and patient satisfaction score were documented as secondary outcomes. Results. Compared with C group, mirtazapine and dexamethasone decreased incidence of clinically significant shivering (74% vs. 16% and 31%, respectively; P < 0.001 ). M and D groups had less hypotensive episodes during 5–25 min after intrathecal injection ( P < 0.001 ). 90 min after SA, tympanic temperatures were lower than baseline values in the three groups ( P < 0.001 ). Pruritus, nausea, and vomiting were more often in C group ( P < 0.001 ), whereas sedation was more frequent in M group ( P < 0.001 ). C group had the lowest satisfaction scores ( P < 0.001 ). Conclusion. Prophylactic administration of mirtazapine or dexamethasone attenuated shivering with minimal hazards in patients scheduled for gynecological surgeries under spinal anesthesia with priority to mirtazapine. The trial is registered with NCT03675555.

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Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial for Prevention of Postspinal Anesthesia Shivering in Gynecological Surgeries: Mirtazapine vs. Dexamethasone

Esmat

Elsayed

El-Hariri

et al. 2022

Anesthesiology Research and Practice

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“…On the other hand, the higher incidence of pruritus, nausea and vomiting in patients of C group could be due to increased consumption of IV meperidine possessing potential side effects such as pruritus, nausea and vomiting [ 4 ]. Also, the investigators reported increased consumption of IV ephedrine in patients of C group which may account for possibility of systemic hypersensitivity reactions [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Postspinal anesthesia shivering in lower abdominal and lower limb surgeries: a randomized controlled comparison between paracetamol and dexamethasone

et al. 2021

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Background Shivering is known to be a frequent complication in patients undergoing surgery under neuraxial anesthesia with incidence of 40–70%. Although many pharmacological agents have been used to treat or prevent postspinal anesthesia shivering (PSAS), the ideal treatment wasn’t found. This study evaluated the efficacy of paracetamol and dexamethasone to prevent PSAS in patients undergoing lower abdominal and lower limb surgeries. Methods Three hundred patients scheduled for surgeries under spinal anesthesia (SA) were allocated into three equal groups to receive a single preoperative dose of oral paracetamol 1 g (P group), dexamethasone 8 mg intravenous infusion (IVI) in 100 ml normal saline (D group) or placebo (C group), 2 h preoperatively, in a randomized, double-blind trial. The primary endpoint was the incidence of clinically significant PSAS. Secondary endpoints included shivering score, the change in hemodynamics, adverse events (e.g., nausea, vomiting and pruritis) and patients` satisfaction. Results Clinically significant PSAS was recorded as (15%) in P group, (40%) in D group and (77%) in C group (P < 0.001). The mean blood pressure values obtained over a 5-25 min observation period were significantly higher in the D group (P < 0.001). Core temperature 90 min after SA was significantly lower in the 3 groups compared to prespinal values (P < 0.001). Nausea, vomiting and pruritis were significantly higher in the C group (P < 0.001). P and D groups were superior to C group regarding the patients’ satisfaction score (P < 0.001). Conclusion Paracetamol and dexamethasone were effective in prevention of PSAS in patients undergoing lower abdominal and lower limb surgeries compared to placebo controls. Trial registration ClinicalTrials.gov Identifier: NCT03679065 / Registered 20 September 2018 - Retrospectively registered, http://www.ClinicalTrial.gov.

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“…The research team strongly suggests trying the use of dexamethasone in geriatric patients and other patient populations with higher risk of postspinal hypotension like obstetric patients. Moreover, ephedrine, by virtue of its synthetic origin, may rarely cause allergic reactions, such as contact allergic responses with topical use (e.g., during ophthalmologic surgery) (30) , and delayed severe dermatitis following IV injection has been reported (31) .…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study

Ashoor

Hussien

Anis

et al. 2021

Preprint

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Background: Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging. Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance. The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension.Methods: 110 patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 hours preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial. Variations in blood pressure and heart rate in addition to the needs of ephedrine and/or atropine following spinal anesthesia (SA) were recorded. SA was achieved using subarachnoid injection of 3 ml hyperbaric bupivacaine 0.5%.Results: Demographic data and the quality of sensory and motor block were comparable between groups. At 5th, 10th minutes post SA; systolic, diastolic and mean arterial pressures were statistically significant higher in D group. At 20th minutes post SA; the obtained blood pressure readings and heart rate changes didn’t show any statistically significance between groups. The need for ephedrine and side effects were statistically significant lower in D group than C group. Conclusion: Post-spinal anesthesia hypotension, nausea, vomiting and shivering in elderly patients were less common after receiving a single preoperative dose of dexamethasone 8 mg IVI than control.

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Ephedrine‐induced erythrodermia: Clinical diagnostic procedure and cross‐sensitivity

Cited by 7 publications

References 18 publications

A Randomized Controlled Trial for Prevention of Postspinal Anesthesia Shivering in Gynecological Surgeries: Mirtazapine vs. Dexamethasone

A Randomized Controlled Trial for Prevention of Postspinal Anesthesia Shivering in Gynecological Surgeries: Mirtazapine vs. Dexamethasone

Postspinal anesthesia shivering in lower abdominal and lower limb surgeries: a randomized controlled comparison between paracetamol and dexamethasone

Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study

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