[Midazolam, propofol, and clonidine for sedation and control of autonomic dysfunction in severe generalized tetanus].
A case of severe tetanus with autonomic dysfunction is reported, describing the adequate response to continuous infusions of both propofol and midazolam, and the successful use of clonidine to control sympathetic over-activity. Tolerance was not observed during the 34 days of propofol and midazolam sedation. Continuously infused clonidine provided good control in combination with sedation and paralysis in this case, and no episodes of cardiovascular derangement were seen, possibly due to the adequate management of filling pressure. Vecuronium was a suitable and manageable muscle relaxant to control skeletal muscle spasms and to facilitate mechanical ventilation.
Peduto
V A
VA
Istituto di Anestesiologia e Rianimazione, Università degli Studi di Cagliari.
Pisanu
G M
GM
Piga
M
M
D000368:Aged; D001341:Autonomic Nervous System / Q000187:drug effects / Q000503:physiopathology*; D003000:Clonidine / Q000494:pharmacology; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D008874:Midazolam / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology; D012720:Severity of Illness Index; D013742:Tetanus / Q000503:physiopathology* / Q000628:therapy
D003000:Clonidine; D008874:Midazolam; D015742:Propofol
Midazolam, propofol e clonidina per la sedazione ed il controllo della disfunzione autonomica nel tetano generalizzato grave.