Dr. SUHAS PRABHAKAR, Dr. Meera Mohanakumar, Dr.UMA MAHESHWARI S
Abstract
A 75 years old female with right eye cataract and no co morbidities admitted for right eye cataract surgery under peribulbar anaesthesia. She was dilated with topical tropicamide with Phenylephrine, Cyclopentolate and flurbiprofen. Patient was slightly restless before the procedure and not cooperative during the procedure, hence Midazolam 0.5 mg iv was given. Procedure was uneventful. One hour after the procedure, she developed confusion, with signs of delirium and psychosis. On examination, she had dry mouth, febrile, HR- 120 beats /min, BP- 100/70 mm Hg, ECG showed Atrial ectopics, CBG-86 mg/dl was recorded. ABG showed hypoxemia with other parameters normal. Oxygen supplementation and i.v fluids- 500 ml RL + 100 ml DNS given. She had acute urinary retention with above signs. Shifted & managed conservatively in ICU, with supportive treatment and observation. She gradually recovered. This highlights the element of anticholinergic (tropicamide) toxicity, and presented for its rarity.
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