| Ketorolac-induced bronchospasm in an aspirin-intolerant patient. | |
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MedLine Citation:
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PMID: 8934961 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A patient, in her mid-twenties, presented with "severe polypoid sinusitis" for sphenoethmoidectomy under general anesthesia. Upon preoperative medical evaluation, it was discovered that she was "allergic" to aspirin and suffered from stress-induced asthma. Before induction of anesthesia, the patient was administered intravenous hydrocortisone and two puffs of her albuterol inhaler to prevent a possible bronchospasm due to stress of the surgery or irritation from the endotracheal tube or other stimuli. The patient was maintained throughout the case with an inhalation anesthetic for its bronchodilatory effect. The surgery proceeded unremarkably, and the patient was then administered ketorolac tromethamine for postoperative pain. After an awake extubation, the patient was transferred to the postanesthesia care unit (PACU) for further monitoring. After 15 min in the PACU, the patient claimed having difficulty breathing. She was then administered terbutaline to produce bronchodilation, but her condition did not improve. Shortly thereafter, aminophylline, midazolam, and methylprednisolone were also administered intravenously. Meanwhile, the patient had to be reintubated and placed on ventilator support with heavy sedation. At this point, it was discovered that ketorolac may have been the cause of this response. Although the patient's condition began to improve, the histamine H1- and H2-receptor blockers diphenhydramine and ranitidine were coadministered. When the patient's condition returned toward normal, she was extubated. The patient's breathing continued to improve. Thereafter, she was transferred to an overnight observation bed and later dismissed to return home. The patient was advised of the episode and warned against future intake of other nonsteroidal antiinflammatory drugs. |
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Authors:
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A H Chen; C R Bennett |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Anesthesia progress Volume: 41 ISSN: 0003-3006 ISO Abbreviation: Anesth Prog Publication Date: 1994 |
Date Detail:
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Created Date: 1996-12-19 Completed Date: 1996-12-19 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0043533 Medline TA: Anesth Prog Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 102-7 Citation Subset: D |
Affiliation:
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Department of Anesthesiology, University of Pittsburgh School of Dental Medicine, Pennsylvania 15261, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anti-Inflammatory Agents, Non-Steroidal / adverse effects* Aspirin / adverse effects, contraindications Asthma* / chemically induced Bronchial Spasm / chemically induced* Dental Care for Chronically Ill* Drug Hypersensitivity* / complications Female Humans Ketorolac Tromethamine Nasal Polyps / surgery Tolmetin / adverse effects, analogs & derivatives* Tromethamine / adverse effects, analogs & derivatives* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 26171-23-3/Tolmetin; 50-78-2/Aspirin; 74103-07-4/Ketorolac Tromethamine; 77-86-1/Tromethamine |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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