Cardiac arrest after oxymetazoline nasal spray.
Oxymetazoline nasal spray is a potent alpha 1-adrenergic agonist commonly used to vasoconstrict blood vessels in the nasal mucosa. In this incident, oxymetazoline nasal spray 0.025% was administered to a 2-year-old patient during general anesthesia for nasal endoscopy. Severe hypertension with reflex bradycardia progressed to sinus arrest and was successfully treated with alropine and cardiopulmonary resuscitation. Decreasing the dose of oxymetazoline and pretreatment with an anticholinergic is recommended.
Department of Anesthesiology, University of South Florida College of Medicine, Tampa 33612-4799, USA.
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D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D001919:Bradycardia / Q000139:chemically induced / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000503:physiopathology; D009296:Nasal Cavity; D010109:Oxymetazoline / Q000008:administration & dosage / Q000009:adverse effects*; D013566:Sympathomimetics / Q000008:administration & dosage / Q000009:adverse effects*
D000889:Anti-Arrhythmia Agents; D013566:Sympathomimetics; D001285:Atropine; D010109:Oxymetazoline