ABSTRACT
En un pequeño porcentaje de pacientes, la estimulación sonora, táctil e incluso nociceptiva en presencia de una ligera profundidad anestésica no provoca la aparición de ondas cerebrales propias de la activación cerebral (ondas α, β), sino que desencadena un enlentecimiento del trazado de las ondas del electroencefalograma. Presentamos el caso de una paciente en la que se registra una actividad cerebral muy enlentecida en el electroencefalograma procesado del monitor del índice biespectral, así como una disminución del valor algorítmico, que dura aproximadamente 5min en el momento de la educción anestésica, coincidiendo con la estimulación sonora y táctil, que tras mantenerla en observación durante 24h en el postoperatorio, no coincide con ningún trastorno a nivel cerebral que lo pueda justificar (AU)
In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, β waves) as would be expected, but leads to a slowed electroencephalogram pattern instead. We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event (AU)
Subject(s)
Humans , Female , Aged , Electroencephalography , Conscience , Monitoring, Intraoperative/instrumentation , Monitoring, Intraoperative/methods , Anesthesia/methods , Hysterectomy/methods , Lymph Node Excision/methods , Propofol/therapeutic use , Fentanyl/therapeutic use , Glasgow Coma ScaleABSTRACT
In a small percentage of patients, sound, touch and even nociceptive stimulation in the presence of a light anaesthetic depth does not cause an electroencephalogram wave pattern of cortical activation (α, ß waves) as would be expected, but leads to a slowed electroencephalogram pattern instead. We report the case of a patient who on emerging from anaesthesia showed very slowed brain activity on the electroencephalogram and reduced algorithmic value, that lasted approximately 5min coinciding with sound and tactile stimulation. After keeping her under observation for 24h during the postoperative period she did not present any brain disorder that could justify that event.
Subject(s)
Consciousness Monitors , Delayed Emergence from Anesthesia/physiopathology , Electroencephalography , Aged , Arousal , Delayed Emergence from Anesthesia/diagnosis , Diagnosis, Differential , Female , Humans , Hypoxia-Ischemia, Brain/diagnosis , Hysterectomy , Physical Stimulation , Uterine Neoplasms/surgeryABSTRACT
La tigeciclina es un antibiótico de amplio espectro estructuralmente similar a la minociclina y que comparte algunos de los efectos adversos de las tetraciclinas. Presentamos el caso de una mujer de 68 años que se trató con tigeciclina por una sepsis de origen desconocido y desarrolló al 5° día de tratamiento un cuadro sugerente de pancreatitis aguda con dolor abdominal junto con elevación de enzimas pancreáticas. Tras descartar diferentes etiologías y basándonos en la escala de Naranjo para la probabilidad de reacciones adversas a fármacos, la tigeciclina fue la causa probable de la pancreatitis aguda, complicación de la cual ha habido 5 comunicaciones en la base de datos del sistema español de farmacovigilancia desde 2009. Se recomienda una vigilancia estrecha de signos y síntomas abdominales durante el uso de tigeciclina, ya que los efectos adversos en el aparato digestivo son los más prevalentes con este fármaco (AU)
Tigecycline is a broad spectrum antimicrobial agent, structurally similar to minocycline and that shares some tetracycline-related side effects. A case report is presented on a 68-year-old female who received tigecycline for a sepsis of unknown origin and who, in the following 5 days, developed abdominal pain and elevated pancreatic enzymes, which suggested acute pancreatitis. After ruling out other origins, and according to the Naranjo adverse drug reaction probability scale, tigecycline was the probable cause of the acute pancreatitis, a complication that has been reported 5 times in the database of the Spanish pharmacosurveillance system since 2009. Close monitoring of abdominal signs and symptoms is recommended during treatment with tigecycline, since adverse effects affecting the digestive system are the most prevalent ones when using this drug (AU)
Subject(s)
Humans , Female , Middle Aged , Pancreatitis/drug therapy , Pancreatitis/surgery , Minocycline/adverse effects , Minocycline/therapeutic use , Drug-Related Side Effects and Adverse Reactions/complications , Drug-Related Side Effects and Adverse Reactions/diagnosis , Pancreatitis/chemically induced , Critical Care , Anti-Bacterial Agents/adverse effectsABSTRACT
Tigecycline is a broad spectrum antimicrobial agent, structurally similar to minocycline and that shares some tetracycline-related side effects. A case report is presented on a 68-year-old female who received tigecycline for a sepsis of unknown origin and who, in the following 5days, developed abdominal pain and elevated pancreatic enzymes, which suggested acute pancreatitis. After ruling out other origins, and according to the Naranjo adverse drug reaction probability scale, tigecycline was the probable cause of the acute pancreatitis, a complication that has been reported 5 times in the database of the Spanish pharmacosurveillance system since 2009. Close monitoring of abdominal signs and symptoms is recommended during treatment with tigecycline, since adverse effects affecting the digestive system are the most prevalent ones when using this drug.
