Intraoperative use of 10% phenylephrine drops can lead to significant systemic absorption causing severe cardiovascular adverse events.
Raises caution for phenylephrine drops in cardiac-risk patients; leaves open incidence and safer alternatives.
The case is reported of a patient who suffered severe acute hypertension, cardiac arrhythmia, and myocardial infarction probably as a direct effect of phenylephrine overdose. Instillation of the drops during surgery probably enhanced the systemic absorption of a significant amount of the drug. Therefore it should be used during surgery with caution, especially in elderly patients and those with cardiovascular disease.
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Yiu‐Kay Lai (1989) studied this question.
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