Myocardial Infarction Thought to be Provoked by Local Epinephrine Injection During Endoscopic Submucosal Dissection

Kim, Hyung Hun; Park, Moo In; Park, Seun Ja; Moon, Won

doi:10.4021/jocmr565w

Cited by 8 publications

(10 citation statements)

References 8 publications

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“…When 1.5% lidocaine with 1 : 100,000 epinephrine was injected (about 7.5 mL) in the nasal mucosa for septoplasty, sudden ventricular tachycardia was observed, followed by cardiac arrest. Kim et al also reported two cases that showed acute elevation of blood pressure with severe chest tightness during endoscopic submucosal dissection after submucosal injection of 1 : 100,000 epinephrine 29. One of the cases was diagnosed as myocardiac infarction.…”

Section: Reviewmentioning

confidence: 97%

“…Kim et al also reported two cases that showed acute elevation of blood pressure with severe chest tightness during endoscopic submucosal dissection after submucosal injection of 1 : 100,000 epinephrine. 29 One of the cases was diagnosed as myocardiac infarction.…”

Section: Reviewmentioning

confidence: 99%

“…Many emergency cases during surgery induced by epinephrine administration have been reported in various fields of medical society, and most of them are related with predisposing cardiovascular complications or drug interactions ( Table 4 ). 28 , 29 , 35 , 41 , 42 Therefore epinephrine application should be carefully considered in such cases.…”

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Cardiovascular effect of epinephrine in endodontic microsurgery: a review

Jang

Kim

2013

Restor Dent Endod

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Epinephrine is one of the most widely-used vasoconstrictors in dental treatment including endodontic microsurgery. However, the systemic safety of epinephrine has been in debate for many years because of its potential risk to cause cardiovascular complications. The purpose of this review was to assess the cardiovascular effect of epinephrine use in endodontic microsurgery. Endodontic microsurgery directly applies epinephrine into the bone cavity, and the amount is reported to be much larger than other dental surgeries. Moreover, when considering that systemic potency of intraosseous application is reported to be comparable to intravenous application, the systemic influence of epinephrine could be increased in endodontic microsurgery. Besides, pre-existing cardiovascular complications or drug interactions can enhance its systemic influence, resulting in increased susceptibility to cardiovascular complications. Although clinical studies have not reported significant complications for patients without severe systemic complications, many epinephrine-induced emergency cases are warning the cardiovascular risk related with pre-existing systemic disease or drug interactions. Epinephrine is a dose-sensitive drug, and its hypersensitivity reaction can be fatal to patients when it is related to cardiovascular complications. Therefore, clinicians should recognize the risk, and the usage of pre-operative patient evaluation, dose control and patient monitoring are required to ensure patient's safety during endodontic microsurgery.

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Section: Reviewmentioning

confidence: 97%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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Cardiovascular effect of epinephrine in endodontic microsurgery: a review

Jang

Kim

2013

Restor Dent Endod

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“…Addition of epinephrine to the injectate has been reported, but its utility has not been clearly established, and adverse events including gastric ischemia and myocardial infarction have been reported. [12][13][14] Recently, injectates with autodissection properties have been evaluated; the promise of these agents lies in their ability to reduce or eliminate the need for submucosal dissection. Mesna (sodium 2-mercaptoethanesulfonate) is a thiol compound that dissolves disulfide bonds in connective tissue between anatomic planes and has been shown to be useful for chemical dissection in surgical fields.…”

Section: Injection Agents and Delivery Devicesmentioning

confidence: 99%

Endoscopic submucosal dissection

Maple¹,

Dayyeh²,

Chauhan³

et al. 2015

Gastrointestinal Endoscopy

226

115

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“…The addition of epinephrine is somewhat controversial. It can help reduce procedural bleeding but was reported to increase the risk of gastric ischemia and myocardial infarction (43,44). Recently, new submucosal injection solutions with audodissection properties are under evaluation (45,46).…”

Section: Creating a Submucosal Fluid Cushionmentioning

confidence: 99%

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

Niu¹,

Abdelfatah²,

Othman³

2017

Ann. Cardiothorac. Surg.

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Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged, the incidence of the esophageal adenocarcinoma has increased over time. Gastroesophageal reflux disease (GERD and obesity are contributing factors to the development of Barrett's esophagus and subsequent development of adenocarcinoma. Early recognition of the disease can lead to resection of esophageal cancer prior to the development of lymphovascular invasion. Various modalities have been implemented to aid identification of precancerous lesions and early esophageal cancer. Chromoendoscopy, narrowband imaging and endoscopic ultrasound examination are typically used for evaluating early esophageal lesions. Recently, confocal laser endomicroscopy (CLE) and volumetric laser scanning were implemented with promising results. Endoscopic management of early esophageal cancer may be done using endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Both techniques allow resection of the mucosa (and possibly a portion of the submucosa) containing the early tumor without interruption of deeper layers. A submucosal injection creating a cushion coupled with snare resection or cap assisted mucosal suction followed by ligation and snare resection are the most common techniques of EMR. EMR can remove lesions less than 2 cm in size en bloc. Larger lesions may require resection in piecemeal fashion. This may limit assessment of the margins of the lesion and orienting the lesion's border. ESD offers en bloc dissection of the lesion regardless of its size. ESD is performed with specialized needle knives, which allow incision followed by careful dissection of the lesion within the submucosal layer. Tumor recurrence after ESD is rare but the technique is labor intensive and has an increased risk of perforation. Esophageal stenosis remains a concern after extensive EMR or ESD. Dilation with balloon or stent placement is usually sufficient to treat post-resection stenosis.

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Myocardial Infarction Thought to be Provoked by Local Epinephrine Injection During Endoscopic Submucosal Dissection

Cited by 8 publications

References 8 publications

Cardiovascular effect of epinephrine in endodontic microsurgery: a review

Cardiovascular effect of epinephrine in endodontic microsurgery: a review

Endoscopic submucosal dissection

Endoscopic submucosal dissection and endoscopic mucosal resection for early stage esophageal cancer

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