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PubMed2003

[Control of blood loss with topical administration of aprotinin after pulmonary tissue decortication and pleurectomy].

The authors were prospectively monitoring postoperative blood loss in 23 patients, in which decortication of the lung tissue and pleurectomy was performed and in which 500,000 KIU of aprotinin was applicated locally to the operating field before closing chest. The study was performed between the years 1998 and 2001. The amount of blood loss was compared to that of a group of 23 patients who underwent the same type of surgery between 1991 and 1998 without use of aprotinin. The postoperative blood loss was monitored 6, 12 and 24 hours after completing the surgery. Postoperative blood loss was lower in the group of patients in which aprotinin was used which was found to be statistically significant compared to the group of nonaprotinin patients.

Administration, Topical↗
PubMedDate not supplied

[Neurotoxic effects induced by the topical administration of cycloplegics. A case report and review of the literature].

INTRODUCTION: We report a patient who developed an acute confusional state with hallucinations after exposure to cycloplejic eye drops, and review the current literature regarding neurotoxicity due to this type of eye drops. CASE REPORT: A 61 year-old man who developed in two occasions confusion, disorientation and vivid visual hallucinations following exposure to a cyclopejic eye drop containing atropine 2%, scopolamine 0.5% and phenylephrine 4%. We performed a literature search regarding neurological complications of cycloplegic eye drops using the PubMed Database and the services of the Virtual Library 'Agencia Lain Entralgo'. The clinical features of all reports in which the original document was obtained are analyzed and summarized. We have summarized the clinical features of 29 patients with neurotoxicity due to cyclopentolate, 19 to atropine, 18 to scopolamine, 7 to homatropine, and 2 to tropicamide. Our patient should be the fourth reported in Spain, being the offending drug in the four cases the same eye drop. The most commonly reported symptoms are visual hallucinations, behavioral disorders/acute psychosis, alterations of consciousness/confusion, restlessness/hyperactivity, ataxia and speech disorders. Many of the patients reported are children and elder. There have been reported some fatal cases, specially related with atropine. CONCLUSIONS: Neurotoxicity related with anticholinergic effects of cycloplegic agents is not infrequent, although it is not well known in our setting; and can cause death in some cases. Exposure to these drugs should be taken in account in the differential diagnosis of acute confusional syndromes.

Administration, Topical↗