Phenylephrine eye drops in pediatric patients undergoing ophthalmic surgery: incidence, presentation, and management of complications during general anesthesia

• DOI: 10.1111/pan.12329
• Publication Date: 2013-12-19T13:43:06Z
• Authors: Fabio Sbaraglia; Nadia Mores; Rossella Garra; Giuseppe Giuratra...; Domenico Lepore; Fernando Molle; Gustavo Savino; Marco Piastra; Silvia Pulitano'; Maria Sammartino
• Keywords: Phenylephrine

Summary Background Phenylephrine eye drops are widely used as mydriatic agent to reach the posterior segment of eye. In literature, many reports suggest a systemic absorption this source severe adverse drug reactions. Hence, we reviewed our experience with topical phenylephrine in ophthalmic surgery. Methods May 2006, following US guidelines publication, standard operating procedure was issued rooms standardize use practice. Two years later, after occurrence cluster serious reactions infants undergoing surgery, review safety and complications incidence performed. Results We observed 451 pediatric patients, 187 met inclusions criteria: Among them, 4 experienced hemodynamic due drops. The major 2.1%. Conclusions different patterns side effects occurred. first one cardiovascular derangement hypertension heart rate alterations; other involved exclusively pulmonary circuit causing early edema. These clinical manifestations, their duration, treatment responses all explainable by alfa1‐adrenergic action phenylephrine. This hypothetic pathogenesis has been confirmed also usefulness direct vasodilators (anesthetic agents) negative outcome occurred past beta‐blockers.