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PubMed1979

Contraindication to the use of ocular phenylephrine in idiopathic orthostatic hypotension.

We studied the effect of topical ocular application of 2.5% phenylephrine ophthalmic solution in patients with idiopathic orthostatic hypotension and in normal subjects. The normal subjects had no pressor effect to the drug. However, the patients with idiopathic orthostatic hypotension, had a marked pressor response. The maximal pressor response in the four patients averaged 44/27 mm Hg. The usual 10% phenylephrine used in practice could have delivered a fourfold greater amount of drug, and presumably would have led to dangerously high blood pressure responses.

Adult↗
PubMed1981

Contraindications for mannitol in aphakic glaucoma.

When prescribing mannitol to decrease intraocular pressure, the physician must be alert to potential complications. A 72-year-old woman suffered obtundation, intractable pulmonary edema, acidemia, and irreversible renal insufficiency despite vigorous hemodialysis. When renal function is compromised, careful monitoring of electrolyte levels, daily urine output, and renal function is necessary with mannitol therapy.

Aged↗
PubMed1995

A bicuspid pulmonary valve is not a contraindication for the arterial switch operation.

There are no obvious criteria concerning the optimal repair for complete transposition with bicuspid pulmonary valve if neither the organic changes in the valve nor the pressure gradient between the left ventricle and the pulmonary trunk are severe. Instead of intraatrial switching or intraventricular rerouting in such circumstances, we have proceeded to the arterial switch procedure in 6 patients with an adequate diameter of the pulmonary valve (greater than 100% of the calculated normal aortic orifice). Postoperative catheterization (at approximately 8 months after the procedures) showed no pressure gradient between the left ventricle and the neoaorta except for a finding of 34 mm Hg difference in 1 patient who had undergone simultaneous subpulmonary myotomy. Echocardiography (7 years later in the longest follow-up) has shown no more than slight regurgitation across the bicuspid neoaortic valve, with no progressive increase of blood velocity across the valve. From these results in the middle term, we conclude that the arterial switch procedure remains an option of choice for patients with initially bicuspid pulmonary valve, providing there is no severe subpulmonary stenosis.

Aorta↗
PubMed1988

Is additional epidural sympathetic block in microvascular surgery contraindicated? A preliminary report.

The use of additional epidural sympathetic block during and after microvascular surgery in the lower extremities to prevent vasospasm is generally agreed on. However, a significant fall in the perfusion rate of the transplants was seen after application of bupivacaine (Marcain) via the epidural catheter. This effect has, to our knowledge, not been described before and is probably caused by the sympathectomy effect of this type of analgesia.

Anesthesia, Epidural↗
PubMed1975

"Positive" bone scan--a contraindication to surgery?

Eleven patients with urologic cancer had an abnormal 99mTc (technetium-99m) bone scan as the sole evidence of metastatic disease. Potentially curative therapy should not be withheld on the basis of a "positive" bone scan if such an area is accessible to selected bone biopsy and proves to be negative for tumor histologically.

Adenocarcinoma↗