1973
DOI: 10.1097/00132586-197308000-00041
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Extreme Epinephrine Sensitivity With a General Anesthesia

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Cited by 5 publications
(7 citation statements)
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“…Three minutes after injection of lidocaine with 1:100,000 epinephrine in his ear canal and postauricular crease, the patient developed sinus tachycardia with short runs of bigeminy followed by bouts of pulmonary edema and hypotension that resolved with intensive care management over the next few days. 4 Wanamaker et al described two more cases, in 12‐ and 15‐year‐old patients undergoing tympanoplasty, that experienced acute onset of hypertension, tachycardia that progressed to ventricular tachycardia, and ultimately ventricular fibrillation. Subsequently, pulmonary edema developed from 3 and 8 mL, respectively, of 1:100,000 epinephrine infiltrated in standard fashion at the beginning of the case.…”
Section: Discussionmentioning
confidence: 99%
“…Three minutes after injection of lidocaine with 1:100,000 epinephrine in his ear canal and postauricular crease, the patient developed sinus tachycardia with short runs of bigeminy followed by bouts of pulmonary edema and hypotension that resolved with intensive care management over the next few days. 4 Wanamaker et al described two more cases, in 12‐ and 15‐year‐old patients undergoing tympanoplasty, that experienced acute onset of hypertension, tachycardia that progressed to ventricular tachycardia, and ultimately ventricular fibrillation. Subsequently, pulmonary edema developed from 3 and 8 mL, respectively, of 1:100,000 epinephrine infiltrated in standard fashion at the beginning of the case.…”
Section: Discussionmentioning
confidence: 99%
“…Woldorf and Pastore [4] also reported the case where pulmonary edema, as well as severe low blood pressure with the systolic blood pressure lower than 30 mmHg and tachycardia, took place after the infiltration of 1% lidocaine 5 ml mixed with 1 : 200,000 epinephrine to the gingivobuccal fold mucosa. In our case report, a hypodermic injection of 2% lidocaine 4 ml mixed with 1 : 200,000 epinephrine was carried out, dividing the total amount into several times, into the part around the retroauricular mastoid, as in the case of the first example.…”
Section: Discussionmentioning
confidence: 99%
“…Accidental intravenous injection of epinephrine or absorption of an excessive amount of it, though it has to be locally infiltrated, can cause cerebral hemorrhage, ventricular arrhythmia, pulmonary edema, or even cardiac arrest. It was reported that even local infiltration of a safe dose of epinephrine can cause severe hypertension, ventricular arrhythmia, acute pulmonary edema, or cardiac arrest [3,4]. The authors have experienced a case of cardiovascular crisis immediately followed by cardiovascular collapse after injection of locally infiltrated epinephrine into a patient with an asymptomatic subarachnoid hemorrhage for facial nerve decompression, and we herein report the case with a related literature survey.…”
mentioning
confidence: 92%
“…The death in December 1995 of a young boy after administration of concentrated epinephrine stands out as a sentinel example of the problem with epinephrine administration in the operating room 1 ; other case reports and anecdotes exist 2,3 . It is, however, extremely difficult to discern the true scope of the problem.…”
Section: Introductionmentioning
confidence: 99%