Morphine Therapy Controls Autonomic Hyperactivity in Tetanus
Authors: MICHAEL A. RIE
Journal: Annals of Internal Medicine (1978)

Brief Reports1 May 1978Morphine Therapy Controls Autonomic Hyperactivity in TetanusMICHAEL A. RIE, M.D., F.A.C.P., ROGER S. WILSON, M.D.MICHAEL A. RIE, M.D., F.A.C.P., ROGER S. WILSON, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-88-5-653 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCardiovascular dysfunction is a well-recognized complication of generalized tetanus in man (1, 2). Both alpha and beta adrenergic blocking agents have been advocated to control arrhythmias and decrease the extreme fluctuations in systemic blood pressure (3). Prys-Roberts and associates (3) reported successful control of sympathetic overactivity with inhalation anesthetics but stressed that toxic effects limited their usefulness. The following case of severe generalized tetanus in the adult associated with autonomic hyperactivity shows successful management with large doses of intravenous morphine.A 43-year-old previously healthy male construction worker developed trismus, generalized seizures, and upper airway obstruction 8 days after lacerating his...References1. TSUEDAOLIVERRICHTER KPR: Cardiovascular manifestations of tetanus. Anesthesiology 40:588-592, 1974 CrossrefMedlineGoogle Scholar2. KERRCORBETTPRYS-ROBERTSCRAMPTON SMITHSPALDING JJCAJ: Involvement of the sympathetic nervous system in tetanus. Lancet 2:236-241, 1968 CrossrefMedlineGoogle Scholar3. PRYS-ROBERTSKERRCORBETTCRAMPTON SMITHSPALDING CJJAJ: Treatment of sympathetic overactivity in tetanus. Lancet 1:542-546, 1969 CrossrefMedlineGoogle Scholar4. WARDMCGRATHWEIL JRJ: Effects of morphine on the peripheral vascular response to sympathetic stimulation. Am J Cardiol 29:659-666, 1972 CrossrefMedlineGoogle Scholar5. ZELISMANSOURCAPONEMASON RERD: The cardiovascular effects of morphine. J Clin Invest 54:1247-1258, 1974 CrossrefMedlineGoogle Scholar6. BAKER A: The central nervous system in tetanus. J Neuropathol Exp Neurol 1:394-405, 1942 CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: MICHAEL A. RIE, M.D., F.A.C.P.; ROGER S. WILSON, M.D.Affiliations: Respiratory Intensive Care Unit and Laboratories of the Department of Anesthesia Harvard Medical School at the Massachusetts General Hospital Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTreatment and Management of Disorders of Neuromuscular Hyperexcitability and Periodic ParalysisTetanus ToxoidTetanusTetanus toxoidNarrative Review: Tetanus—A Health Threat After Natural Disasters in Developing CountriesMajid Afshar, MD, Mahesh Raju, MD, David Ansell, MD, MPH, and Thomas P. Bleck, MDTreatment and Management of Disorders of Neuromuscular HyperexcitabilityTétanosTetanus toxoidAutonomic nervous system dysfunction predicts poor prognosis in patients with mild to moderate tetanusTetanusMagnesium sulfate for control of muscle rigidity and spasms and avoidance of mechanical ventilation in pediatric tetanusRespiratory Failure in TetanusEvaluation of autonomic nervous system function with spectral analysis of heart rate variability in a case of tetanusTetanus: a review of the literatureUltrastructural localization of the binding fragment of tetanus toxin in putative ?-aminobutyric acidergic terminals in the intermediolateral cell column: A potential basis for sympathetic dysfunction in generalized tetanusTetanus: Pathophysiology and ManagementSevere Tetanus in a Patient with Ulcerating Inflammatory Breast Carcinoma: A Case Report and Review of ManagementLetters to the EditorLetters to the EditorPain Relief and SedationTetanusThe use of continuous atropine infusion in the management of severe tetanusUse of esmolol to control autonomic instability of tetanusTetanus: Pathophysiology, management, and prophylaxisManagement of autonomic dysfunction in severe tetanus: the use of magnesium sulphate and clonidineManagement of autonomic dysfunction in severe tetanus: The use of magnesium sulphate and clonidineClinical Aspects of TetanusCardiovascular responses to stress: the role of opioid peptidesLong-term continuous spinal Anesthesia in severe tetanus with autonomic disturbanceTetanus in children: an 11-year reviewThe cardiovascular actions of morphine and the endogenous opioid peptidesAcupuncture used as an adjunct in the treatment of a horse with tetanusTetanusCurrent topics in tetanus 1 May 1978Volume 88, Issue 5Page: 653-654KeywordsAnestheticsArrhythmiaBlood pressureCardiovascular therapyEpileptic seizuresInhalationMorphineTetanus ePublished: 1 December 2008 Issue Published: 1 May 1978 PDF downloadLoading ...