ABSTRACT
Pulmonary complications of long-term amiodarone use are well known. However, acute pneumonitis causing respiratory distress with short-term administration of amiodarone although rare is associated with high mortality. Early diagnosis and treatment with glucocorticoids significantly decrease associated mortality and morbidity. We are reporting one such case of amiodarone-induced pulmonary pneumonitis and its complete resolution with short-course glucocorticoid therapy. Thus, every clinician prescribing amiodarone should be well acquainted with this entity.
ABSTRACT
OBJECTIVE: The aim of this study is to determine safety and feasibility of conscious sedation using dexmedetomidine for transcatheter atrial septal defect (ASD) device closure. MATERIAL AND METHODS: A retrospective institutional review of transcatheter ASD device closure without endotracheal intubation over 18 months. The protocol included topical oropharyngeal anesthesia using lignocaine followed by dexmedetomidine bolus 1 µg/kg intravenously over 10 min and maintenance dose 0.2-0.7 µg/kg/h. Ramsay sedation score 2-3 was maintained. Patients were analyzed regarding demographic profile, device size, procedure time, anesthesia time, recovery time, hospital stay, and any hemodynamic or procedural complications. RESULTS: A total of 43 patients with mean age 31.56 ± 13.74 years (range: 12-56 years) were analyzed. Mean anesthesia duration was 71.75 + 21.08 min. Mean recovery time was 7.6 ± 3.01 min. 16 females and one male patient required additional propofol with a mean dose of 30.8 ± 10.49 mg. No hemodynamic instability was noted. No patient required general anesthesia with endotracheal intubation. The procedure was successful in 93.02% of patients. Four patients developed atrial fibrillation. All patients were satisfied. CONCLUSION: Conscious sedation using dexmedetomidine is a safe and effective anesthetic technique for percutaneous ASD closure.
