Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Critical Care
Volume 2017 (2017), Article ID 4504207, 4 pages
https://doi.org/10.1155/2017/4504207
Case Report

Significant Bradycardia in Critically Ill Patients Receiving Dexmedetomidine and Fentanyl

1Rutgers-Robert Wood Johnson Medical School, Department of Emergency Medicine, One Robert Wood Johnson Place, MEB 389, New Brunswick, NJ 08901, USA
2Ernest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Rd., Piscataway Township, NJ 08854, USA
3Saint Peter’s University Hospital, 254 Easton Ave., New Brunswick, NJ 08901, USA

Correspondence should be addressed to Channing Hui; ude.sregtur.smjwr@hciuh

Received 27 April 2017; Revised 18 July 2017; Accepted 3 August 2017; Published 6 September 2017

Academic Editor: Ricardo Oliveira

Copyright © 2017 Channing Hui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. J. Barr, G. L. Fraser, K. Puntillo et al., “Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit,” Critical Care Medicine, vol. 41, no. 1, pp. 263–306, 2013. View at Publisher · View at Google Scholar · View at Scopus
  2. F. Yuan, H. Fu, P. Yang et al., “Dexmedetomidine-fentanyl versus propofol-fentanyl in flexible bronchoscopy: a randomized study,” Experimental and Therapeutic Medicine, vol. 12, no. 1, pp. 506–512, 2016. View at Publisher · View at Google Scholar · View at Scopus
  3. R. Virtanen, J.-M. Savola, V. Saano, and L. Nyman, “Characterization of the selectivity, specificity and potency of medetomidine as an α2-adrenoceptor agonist,” European Journal of Pharmacology, vol. 150, no. 1-2, pp. 9–14, 1988. View at Publisher · View at Google Scholar · View at Scopus
  4. S. M. Hoy and G. M. Keating, “Dexmedetomidine: A review of its use for sedation in mechanically ventilated patients in an intensive care setting and for procedural sedation,” Drugs, vol. 71, no. 11, pp. 1481–1501, 2011. View at Publisher · View at Google Scholar · View at Scopus
  5. R. Gertler, HC. Brown, DH. Mitchell, and EN. Silvius, Dexmedetomidine, a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent), vol. 14, 14, 13–21, 2001.
  6. G. M. Jones, C. V. Murphy, A. T. Gerlach, E. M. Goodman, and L. J. Pell, “High-Dose Dexmedetomidine for Sedation in the Intensive Care Unit: An Evaluation of Clinical Efficacy and Safety,” Annals of Pharmacotherapy, vol. 45, no. 6, pp. 740–747, 2011. View at Publisher · View at Google Scholar · View at Scopus
  7. T. J. Ebert, J. E. Hall, J. A. Barney, T. D. Uhrich, and M. D. Colinco, “The effects of increasing plasma concentrations of dexmedetomidine in humans,” Anesthesiology, vol. 93, no. 2, pp. 382–394, 2000. View at Publisher · View at Google Scholar · View at Scopus
  8. C. J. Ice, H. A. Personett, E. N. Frazee, R. A. Dierkhising, R. Kashyap, and R. A. Oeckler, “Risk factors for dexmedetomidine-associated hemodynamic instability in noncardiac intensive care unit patients,” Anesthesia and Analgesia, vol. 122, no. 2, pp. 462–469, 2016. View at Publisher · View at Google Scholar · View at Scopus
  9. P. W. H. Peng and A. N. Sandler, “A review of the use of fentanyl analgesia in the management of acute pain in adults,” Anesthesiology, vol. 90, no. 2, pp. 576–599, 1999. View at Publisher · View at Google Scholar · View at Scopus
  10. P. S. Sebel, J. G. Bovill, R. A. A. Boekhorst, and N. Rog, “Cardiovascular effects of high‐dose fentanyl anaesthesia,” Acta Anaesthesiologica Scandinavica, vol. 26, no. 4, pp. 308–315, 1982. View at Publisher · View at Google Scholar · View at Scopus
  11. M. Irnaten, S. A. Aicher, J. Wang et al., “μ-opioid receptors are located postsynaptically and endomorphin-1 inhibits voltage-gated calcium currents in premotor cardiac parasympathetic neurons in the rat nucleus ambiguus,” Neuroscience, vol. 116, no. 2, pp. 573–582, 2003. View at Publisher · View at Google Scholar · View at Scopus
  12. K. J. S. Griffioen, P. Venkatesan, Z.-G. Huang et al., “Fentanyl inhibits GABAergic neurotransmission to cardiac vagal neurons in the nucleus ambiguus,” Brain Research, vol. 1007, no. 1-2, pp. 109–115, 2004. View at Publisher · View at Google Scholar · View at Scopus
  13. J. R. Horn, P. D. Hansten, and L. N. Chan, “Proposal for a new tool to evaluate drug interaction cases,” Annals of Pharmacotherapy, vol. 41, no. 4, pp. 674–680, 2007. View at Publisher · View at Google Scholar · View at Scopus
  14. M. T. Salmenperä, F. Sziam, and C. C. Hug Jr., “Anesthetic and hemodynamic interactions of dexmedetomidine and fentanyl in dogs,” Anesthesiology, vol. 80, no. 4, pp. 837–846, 1994. View at Publisher · View at Google Scholar · View at Scopus
  15. S. M. Crain, B. Crain, and M. H. Makman, “Pertussis toxin blocks depressant effects of opioid, monoaminergic and muscarinic agonists on dorsal-horn network responses in spinal cord-ganglion cultures,” Brain Research, vol. 400, no. 1, pp. 185–190, 1987. View at Publisher · View at Google Scholar · View at Scopus
  16. Precedex, Precedex™ [package insert], Hospira, Lake Forest, Ill, USA, 2016.