Severe Hypertensive Response to Atropine Therapy for Bradycardia Associated with Dexmedetomidine: Case Report and Literature Review

Figures & data

Table 1 Overview of Published Dexmedetomidine-Induced Hypertension

Author	Year	Sex	N	Clinical Findings
Erkonen G et al^Citation6	2008	M	1	A 2-year-old male with traumatic injury to the brain developed hypertension after dexmedetomidine (4 µg/kg/h) infusion for several hours.
Shah S et al^Citation7	2008	M	1	An 18-year-old male (70 kg) with acute transverse myelitis suffered severe hypertension plus bradycardia after a loading dose of dexmedetomidine for sedation for magnetic resonance imaging.
Mason K P et al^Citation8	2009	M	3	Three boys suffered bradycardia when they received high-dose dexmedetomidine for sedation, and the bradycardia was treated using glycopyrrolate (5.0 µg/kg, i.v.). Each child had immediate and exaggerated hypertension in response to glycopyrrolate.
Kukoyi A T et al^Citation9	2012	F	2	Two cases where adult females, after withdrawal syndrome, experienced the sudden onset of hypertension, tachycardia, agitation and anxiety after rapid discontinuation of prolonged (5–7 d) infusions of dexmedetomidine.
Muthiah T et al^Citation10	2016	M	1	A 34-year-old male scheduled to undergo general anesthesia with a conscious fiber-guided nasotracheal tube because of a fractured mandible. The initial infusion rate was 1 µg/kg/h dexmedetomidine, delivered as a loading dose in 20 min. The blood pressure increased gradually from 128/86 mm Hg to 200/110 mm Hg, and the case suffered a severe headache.

Erkonen G, Lamb F, Tobias JD. High-dose dexmedetomidine-induced hypertension in a child with traumatic brain injury. Neurocritical Care. 2008;9(3):366. doi:10.1007/s12028-008-9102-y

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Shah S, Sangari T, Qasim M, et al. Severe hypertension and bradycardia after dexmedetomidine for radiology sedation in a patient with acute transverse myelitis. Pediatr Anesthesia. 2008;18(7):681–682. doi:10.1111/j.1460-9592.2008.02521.x

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Mason KP, Zgleszewski S, Forman RE, et al. An exaggerated hypertensive response to glycopyrrolate therapy for bradycardia associated with high-dose dexmedetomidine. Anesthesia Analg. 2009;108(3):906–908. doi:10.1213/ane.0b013e3181948a6f

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Kukoyi AT, Coker SA, Lewis LD, et al. Two cases of acute dexmedetomidine withdrawal syndrome following prolonged infusion in the intensive care unit Report of cases and review of the literature. Hum Exp Toxicol. 2012;32(1):107–110.

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Muthiah T, Moni A, Mathews L, et al. Intravenous labetolol in treating hypertensive crisis following dexmedetomidine infusion for procedural sedation. J Clin Anesth. 2016;29:30–32. doi:10.1016/j.jclinane.2015.10.011

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