Pediatric Safety of Tizanidine

Henney, Herbert R.; Chez, Michael G.

doi:10.2165/11316090-000000000-00000

Cited by 19 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the prescription of Clonidine was associated with severe decrease of blood pressure in cardiothoracic and non-cardiothoracic surgeries in several studies (16), in our study neither severe hypotension( below 80 mmHg) nor sever bradycardia( below 50 beats/minute) resulted from Tizanidine use and the drug was tolerated with no considerable side-effect, the most common of which being mouth dryness. In addition, the effect of Tizanidine on required propofol dosage for anesthesia maintenance has been surveyed in this study.…”

Section: Discussioncontrasting

confidence: 52%

Evaluation of Oral Tiazinidine Effects on [intraoperative] Hemodynamic Responses During Direct Laryngoscopy Under General Anesthesia

Tabari

Alipour

Esalati

2013

Iran Red Crescent Med J

View full text Add to dashboard Cite

BackgroundDirect laryngoscopy and tracheal intubation can result in blood pressure and heart rate increase which in turn may lead to myocardial ischemia, cerebral hemorrhage, and even death in susceptible patients. Tizanidine is α2-receptor agonists that suppresses central sympathetic system.ObjectivesThis study evaluates the effects of oral Tizanidine on hemodynamic responses during operations and aims to determine the appropriate Propofol dosage to maintain anesthesia under BIS monitoring.Materials and MethodsA double-blind clinical trial has been performed on 70 candidates for elective abdominal surgery undergoing general anesthesia in Educational Hospital of Ghaem, Mashhad, Iran. 35 randomly selected patients (the case group) were given 4 mg of oral Tizanidine 90 minutes before the induction of anesthesia whereas the remaining subjects (the control group) were given placebo. Blood pressure and heart rate before and after induction of anesthesia, and after intubation and extubation, existence of postoperative shivering, and the needed Propofol dosage were measured and recorded. Data analysis was done with T-test and Chi-squared test, using SPSS software version 16.ResultsVariations of blood pressure and heart rate after anesthesia induction, intubation and extubation were less in Tizanidine group generally. Postoperative shivering was reported in 28.6% and 11.4% of patients in control and case group respectively. Average propofol needed dose for anesthesia maintenance in case group was 25% less than the needed amount in the control group.ConclusionsUsing oral Tizanidine as a premedication, yielded stability in blood pressure and heart rate during surgery and decreased required Propofol. Considering its short duration of action, Tizanidine use as a premedication is recommended for sedation and stabilization of hemodynamic responses during the operations.

show abstract

Section: Discussioncontrasting

confidence: 52%

Evaluation of Oral Tiazinidine Effects on [intraoperative] Hemodynamic Responses During Direct Laryngoscopy Under General Anesthesia

Tabari

Alipour

Esalati

2013

Iran Red Crescent Med J

View full text Add to dashboard Cite

show abstract

“…They implied that the overall safety of tizanidine in the pediatric group was good. None of the patients in the present study had a special problem during anesthesia or after it and we did not observe significant differences between the two groups concerning the side effects of the drug (13).…”

Section: Discussioncontrasting

confidence: 58%

Effect of oral tizanidine on prolongation of intrathecal lidocaine

Taheri

Hashemian

Noroozi

et al. 2018

J Emerg Pract Trauma

View full text Add to dashboard Cite

Dear EditorScuba diving is associated with an important risk of developing decompression sickness secondary to formation of gas bubbles inside the body. The latter is formed mainly by nitrogen in the body on the diver's way to the surface (1,2). In some cases, it might injure the central nervous system. Several decompression cases that have been associated with neurologic symptoms are described in the literature; however, brain multi-infarct with lethal outcome has never been described. A 41-year-old male, came to the ER with clinical suspicion of decompression sickness (he dived for 15 minutes at a depth of 50 m). Among his health history, he was a heavy smoker, 30 minutes after leaving the water; he suddenly had dysarthria and vertigo. Upon admission, the patient had a poor general condition, Glasgow Coma Scale (GCS) 9 points, and horizontal nystagmus with right hemiparesis 4/5. Brain magnetic resonance imaging (MRI) demonstrated multiple cerebral and cerebellar infarctions. Echocardiography did not reveal the presence of patent foramen ovale (Figure 1). The patient was required to be transferred to intensive care unit and to a hyperbaric chamber session. He progressed to hemodynamic instability, dying within 36 hours after admission. Brain multi-infarct and decompression sickness© 2018 The Author(s). Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Decompression sickness is thought to be associated with thrombotic events due to intravascular gas bubbles. It is accepted that mechanical abrasion to vessel's walls may induce endothelial dysfunction and activation of the blood cells that are responsible to start the inflammatory reaction, vasomotor dysfunction, platelet aggregation pathway and coagulopathy. This disease has been classified into two types: type I and II, based on the severity of signs and symptoms. Type I is a mild form that requires less recompression and treatment, type II is associated with neurologic symptoms (3). The latter requires an extensive therapy and may lead to significant neurologic sequelae. Our case report represents a type II decompression sickness. It is known that the delay to start recompression treatment represents a poor prognosis. Early start of hyperbaric therapy will reduce the size of the gas bubbles, improve perfusion and re-oxygenate ischemic tissue before late inflammatory processes might occur. These include cytokines, platelet activation and complement activation (4,5). Ethical issuesNot applicable. Authors' contributionsAll authors contributed equally. Jept Journal of Emergency Practice and TraumaLetter to Editor

show abstract

“…It has been reported that the main site where α2-AR agonists function is the spinal cord ( 29 , 30 ). Tizanidine, a highly selective α2-AR agonist, is widely used to treat the spasms, cramping, and tightness of muscles caused by multiple sclerosis, spastic diplegia, back pain, or some other injuries to the spine or the central nervous system ( 31 , 32 ). Previous studies have shown that tizanidine exerts analgesic potential in neuropathic pain ( 33 , 34 ).…”

Section: Discussionmentioning

confidence: 99%

Tizanidine exerts anti-nociceptive effects in spared nerve injury model of neuropathic pain through inhibition of TLR4/NF-κB pathway

et al. 2018

View full text Add to dashboard Cite

Recently, α2-adrenoceptors (α2-AR) agonists have been shown to have anti-nociceptive effects and thus may become a promising therapeutic strategy for neuropathic pain. tizanidine is a highly selective α2-AR agonist, but the effect mechanism of tizanidine in neuropathic pain remains largely unknown. The present study investigated whether tizanidine has anti-nociceptive effects in spared nerve injury (SNI) model of neuropathic pain in rats, as well as explored the underlying molecular mechanism. We found that the rats in SNI group showed significantly higher mechanical and thermal hyperalgesia, accompanied with increased production of proinflammatory cytokines including interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α), as well as the activation of Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling. PDTC, an inhibitor of TLR4/NF-κB signaling, could significantly attenuate the SNI-induced mechanical and thermal hyperalgesia and the production of proinflammatory cytokines. Moreover, treatment with tizanidine also attenuated the SNI-induced mechanical and thermal hyperalgesia, suppressed production of the proinflammatory cytokines, and inhibited the activation of TLR4/NF-κB pathway, which could be reversed by pretreatment with BRL44408, a selective α2-AR antagonist. Taken these findings together, we demonstrated that tizanidine has anti-nociceptive effects on neuropathic pain via inhibiting the production of proinflammatory cytokines through suppressing the activation of TLR4/NF-κB p65 signaling pathway.

show abstract

Pediatric Safety of Tizanidine

Cited by 19 publications

References 36 publications

Evaluation of Oral Tiazinidine Effects on [intraoperative] Hemodynamic Responses During Direct Laryngoscopy Under General Anesthesia

Evaluation of Oral Tiazinidine Effects on [intraoperative] Hemodynamic Responses During Direct Laryngoscopy Under General Anesthesia

Effect of oral tizanidine on prolongation of intrathecal lidocaine

Tizanidine exerts anti-nociceptive effects in spared nerve injury model of neuropathic pain through inhibition of TLR4/NF-κB pathway

Contact Info

Product

Resources

About