Propofol-Induced Masseter Muscle Spasm in a Woman with a Major Depressive Disorder

Saeidi, Mozhgan; Alikhani, Rosa; Hormati, Ahmad; Sabouri, Seyed Mehdi; Aminnejad, Reza

doi:10.5812/aapm.78748

Cited by 8 publications

(9 citation statements)

References 5 publications

(6 reference statements)

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“…Propofol is another possible reason for muscle rigidity of the masseter muscle. A previous case of masseter muscle rigidity with propofol was attributed to serotonin syndrome, but the patient in our case was not administered serotonin-related drugs [8]. In addition, this hypnotic drug is used to reduce muscle rigidity caused by other drugs such as succinylcholine in usual practice [9].…”

Section: Discussionmentioning

confidence: 77%

Masseter Muscle Rigidity After Initiating Monitored Anaesthesia Care of Propofol and Remifentanil

Kim¹,

Kim²,

Sun³

et al. 2020

SCR

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Masseter muscle rigidity can be seen following administration of opioids, succinylcholine, and nondepolarizing muscle relaxants. We report a case of a 56-year-old male patient in a “Cannot Intubate Cannot Ventilate Situation” due to masseter muscle rigidity after initiating monitored anaesthesia care (MAC) with remifentanil and propofol using target-controlled infusion in procedural cardiology. For rapid effect and equilibrium between plasma-concentration and effect site-concentration using target-controlled infusion, remifentanil overdose is possible during the induction period of MAC. Moreover, the presence of propofol could result in a significantly greater remifentanil concentration. To manage masseter muscle rigidity, muscle relaxants and emergent ventilation systems should be prepared to secure airway maintenance. In addition, alternative airway management devices and techniques should be on hand even if no airway difficulties are expected.

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Section: Discussionmentioning

confidence: 77%

Masseter Muscle Rigidity After Initiating Monitored Anaesthesia Care of Propofol and Remifentanil

Kim¹,

Kim²,

Sun³

et al. 2020

SCR

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“…Three anesthesia related mortality cases of our study happened due to fatal dysrhythmia, aspiration pneumonia and prolonged apnea. We didn’t find any other uncommon complication of propofol based anesthesia (9).…”

Section: Discussionmentioning

confidence: 90%

“…There are a variety of sedative/anesthetic approaches to enhance patients’ safety and comfort alongside providing the endoscopists' satisfaction (5-7). Propofol based deep sedation is one of the safest and the most efficacious anesthetic methods in many centers (8, 9). Administering a hypnotic medication such as propofol should be under direct supervision of an anesthesiologist who is expert enough in airway management.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Anesthetic and Gastrointestinal Complications of Endoscopic Retrograde Cholangiopancreatography

et al. 2019

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic method for treatment of many biliary diseases. With respect to rapid recovery and more patient comfort, this procedure is currently performed under light general anesthesia (GA) or conscious sedation. Objectives: The current study aimed to clarify that intravenous sedation or light general anesthesia can be performed without great fear of anesthesia related complications in ERCP patients and sedative doses of propofol can be used safely in outpatient settings under the supervision of an expert anesthesiologist. Methods: This is a cross-sectional study on 1023 ERCP patients under light GA during 2014-2018 in Qom, Shahid Beheshti Hospital. Data were collected by a checklist and were analyzed by using chi-square test in SPSS V.22. Results: From 1023 patients, 501 (48.97 %) were male and 522 (51.03 %) were female with a mean age of 47.2 ± 6.7 years. The most common finding in ERCP was choledocholithiasis (76.15 %). The most common complication was hemodynamic instability (37.01 %) followed by desaturation (11.65 %) both of them ware anesthesia related. Prevalence of GI (gastrointestinal) related complications was 13.39 %. The most common GI related complications were pancreatitis (7.92 %) and bleeding (3.32 %). Total mortality rate was 0.88 %. Conclusions: ERCP-related complications are inevitable but can be controlled by early diagnosis and clinical experience. Severe complications and high risk patients may increase the mortality and morbidity of the procedure. Anesthesia related complications are more frequent than GI related unwanted events. Fortunately, the most common anesthesia related complications are readily manageable and are minor in nature when an expert anesthesiologist is present in the scene. Close monitoring of the patient's vital signs should be the mainstay of the safe procedure.

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“…Occurrence of rare complications such as aphasia 18 or masseter spasm 9 repeatedly notify the significance of close observation and implementation of all standard monitoring in endoscopy room. It is important to be aware of the risk of death in an apparently simple procedure such as GI endoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…The most frequent anesthesia related complication in these group of patients, is hypotension specially in anesthesia induced by rapid injection of hypnotics such as Propofol. 5,8,9 Although, most of these complication can be managed by the expert anesthesiologist, some of them can be fatal then careful attention and preparation for each possible scenario is prudent.…”

Section: Introductionmentioning

confidence: 99%

Anesthesia Related Complications of Gastrointestinal Endoscopies; A Retrospective Descriptive Study

Hormati

Mohammadbeigi

Mousavi

et al. 2019

Middle East J Dig Dis

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BACKGROUND Gastrointestinal endoscopic procedures are widely used for diagnostic and therapeutic measures. Analgesia and sedation/anesthesia are inseparable parts of these studies and their related complications are inevitable.METHODS In a retrograde descriptive study in Shahid Beheshti Hospital, affiliated to Qom University of Medical Sciences, Qom, Iran from March 2013 to March 2017, we gathered information regarding common anesthesia related complications and analyzed them.RESULTS 44659 procedures were performed during the study period and records of 21342 men (47.79%) and 23317 women (52.21%) were evaluated. Hemodynamic instability (9998; 22.39%), dysrhythmia (1600; 3.58%), desaturation (608; 1.36%), prolonged apnea (34; 0.08%), aspiration (43; 0.10%), postoperative nausea and vomiting (PONV) (636; 1.42%), headache (106; 0.24%), delirium (51; 0.11%), aphasia (1; 0.00%), masseter muscle spasm (1; 0.01%), myocardial infarction (2; 0.00%), and death (5; 0.01%) were seen in the patients.CONCLUSION Sedation/anesthesia is enough safe in gastrointestinal endoscopic procedures to enhance the patients’ satisfaction and cooperation. If anesthesia with spontaneous breathing and unsecure airway is selected for this purpose, vigilance of anesthesia provider will be the key element of uneventful and safe procedure.

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Propofol-Induced Masseter Muscle Spasm in a Woman with a Major Depressive Disorder

Cited by 8 publications

References 5 publications

Masseter Muscle Rigidity After Initiating Monitored Anaesthesia Care of Propofol and Remifentanil

Masseter Muscle Rigidity After Initiating Monitored Anaesthesia Care of Propofol and Remifentanil

Prevalence of Anesthetic and Gastrointestinal Complications of Endoscopic Retrograde Cholangiopancreatography

Anesthesia Related Complications of Gastrointestinal Endoscopies; A Retrospective Descriptive Study

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