Chemical Burn Secondary to Propofol Extravasation

Sharma, Rahul; Yoshikawa, Hana; Abisaab, Josyann

doi:10.5811/westjem.2011.6.6813

Cited by 11 publications

(10 citation statements)

References 4 publications

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“…[11][12][13][14] The above does not usually lead to tissue necrosis due to the favorable chemical properties, including a neutral pH and is otonicity of propofol. [15] In our case we followed up our patient for fifteen days only to find that he did not show any signs of tissue necrosis.…”

Section: Discussionmentioning

confidence: 74%

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Devi¹,

Balasubramanyam²,

Omkarappa³

et al. 2014

jemds

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Section: Discussionmentioning

confidence: 74%

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Devi¹,

Balasubramanyam²,

Omkarappa³

et al. 2014

jemds

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“…Intravenous anesthetic agents including thiamylal, thiopentone, propofol, and etomidate are strongly irritant to vessels and easily cause phlebitis, chemical burn, or tissue necrosis via unintentional extravasations [14]. In addition, propofol and nalbuphine intravenous bolus injection may induce serious injection pain [15].…”

Section: Discussionmentioning

confidence: 99%

Establish a perioperative check forum for peripheral intravenous access to prevent the occurrence of phlebitis

Chiu

Lee

Hsu

et al. 2015

The Kaohsiung J of Med Scie

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The prevalence of intravenous (IV) catheter-related infections is 0.5 per 1000 device days, and these infections cause tenderness, erythema, swelling and phlebitis. Catheter-related bloodstream infections (CRBSI) may independently increase hospital costs and length of stay; the aim of the study was to set up a standard operating procedure (SOP) for the maintenance of peripheral vein catheter patency and the prevention of IV catheter-related complications. This is a retrospective study, enrolling patients who received anesthesia between April 2010 and January 2011. The study included 1 month of pretest phase, and 3 months each of "notification" phase, "observation" phase and "end" phase, respectively. The cannulations were set up by surgical ward nurses following the SOP on establishing peripheral intravenous catheter in our hospital. The cannulation sites were then examined before surgery and postoperatively by registered nurse anesthetists using the Baxter Scale. We also tried to set up a feedback circuit to let ward nurses know about the IV patency rate. As a result, 14,682 patients were enrolled in the study. The incidence of IV therapy-related adverse events was 0.78% in the notification phase, 0.43% in the observation phase, and 0.13% in the end phase. Overall IV therapy-related events declined significantly (p < 0.01), and the presence of phlebitis was associated with age (p < 0.05). An SOP established to assess IV patency through a checklist can reduce phlebitis and improve quality. The checklist increases ward nurses' and nurse anesthetists' awareness of IV patency, and the feedback circuit substantially reduces IV event rate.

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“…It is well known that thiopental can act as a vesicant [7] and propofol can act as an irritant [8] , [9] , [10] , [11] . However, few reports have shown the vesicant effects of propofol [12] , [13] , [14] . Thus, the risk of skin lesions induced by propofol extravasation is understood incompletely because data are limited to a few case reports.…”

Section: Introductionmentioning

confidence: 99%

Injury due to extravasation of thiopental and propofol: Risks/effects of local cooling/warming in rats

Shibata

Yokooji

Itamura

et al. 2016

Biochemistry and Biophysics Reports

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Inadvertent leakage of medications with vesicant properties can cause severe necrosis in tissue, which can have devastating long-term consequences. The aim of this study was to evaluate the extent of extravasation injury induced by thiopental and propofol, and the effects of cooling or warming of local tissue on extravasation injury at macroscopic and histopathologic levels. Rats were administered intradermally thiopental (2.5 mg/100 µL) or propofol (1.0 mg/100 µL). Rats were assigned randomly to three groups: control (no treatment), cooling and warming. Local cooling (18–20 °C) or warming (40–42 °C) was applied for 3 h immediately after agent injection. Lesion sizes (erythema, induration, ulceration, necrosis) were monitored after agent injection. Histopathology was evaluated in skin biopsies taken 24 h after agent injection. Thiopental injection induced severe skin injury with necrosis. Peak lesions developed within 24 h and healed gradually 18–27 days after extravasation. Propofol induced inflammation but no ulceration, and lesions healed within 1–2 days. Local cooling reduced thiopental- and propofol-induced extravasation injuries but warming strongly exacerbated the skin lesions (e.g., degeneration, necrosis) induced by extravasation of thiopental and propofol. Thiopental can be classified as a “vesicant” that causes tissue necrosis and propofol can be classified as an “irritant”. Local cooling protects (at least in part) against skin disorders induced by thiopental and propofol, whereas warming is harmful.

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Chemical Burn Secondary to Propofol Extravasation

Cited by 11 publications

References 4 publications

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Establish a perioperative check forum for peripheral intravenous access to prevent the occurrence of phlebitis

Injury due to extravasation of thiopental and propofol: Risks/effects of local cooling/warming in rats

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