title: Fentanyl therapy controls autonomic hyperactivity in tetanus.
abstract: This report describes the use of fentanyl in severe tetanus after failure of established therapeutic modalities (heavy sedation, neuromuscular blockade and ventilation). Cardiovascular instability accompanying severe tetanus secondary to sympathetic overactivity and raised catecholamine levels is associated with a mortality of over 50%. In this clinical situation, a variety of drugs with a primary or secondary action on the cardiovascular system has been used with varying success. The following case of severe generalised tetanus in the adult associated with autonomic hyperactivity, was successfully managed with large doses of intravenous fentanyl.
authors.affiliation: Service de Réanimation, Centre Hospitalier General de Valenciennes, France.
authors.forename: A V
authors.initials: AV
authors.lastname: Moughabghab
authors.forename: G
authors.initials: G
authors.lastname: Prevost
authors.forename: C
authors.initials: C
authors.lastname: Socolovsky
mesh_terms: D000368:Aged; D001341:Autonomic Nervous System / Q000187:drug effects; D005283:Fentanyl / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009294:Narcotics / Q000627:therapeutic use*; D013742:Tetanus / Q000188:drug therapy*; D013743:Tetanus Antitoxin / Q000008:administration & dosage
chemical_list: D009294:Narcotics; D013743:Tetanus Antitoxin; D005283:Fentanyl