Korean J Anesthesiol.  2003 Jan;44(1):142-145. 10.4097/kjae.2003.44.1.142.

Accidental Intrathecal Adminstration of Acetylcysteine: A case report

• Chung CJ
• Baik CY
• Kim SH
• Chin YJ

• KMID: 1860719
• DOI: http://doi.org/10.4097/kjae.2003.44.1.142

Abstract

We report a case of accidental intrathecal administration of Nucomyt(R)(acetylcysteine), a mucolytic agent used for intratracheal instillation. A 21-year-old healthy female with a complete syndactyly at the 4th and 5th toes was scheduled for a web release under spinal anesthesia. Immediately after accidental intrathecal administration of Nucomyt(R)2.4 ml instead of bupivacaine for spinal anesthesia, tonic extension developed at first in the lower extremities and then the upper extremities, too. Thiopental sodium 200 mg was injected intravenously twice. Endotracheal general anesthesia with N2O- enflurane-vecuronium was maintained for the operation for about two hours. For about 1 hour after emergence of general anesthesia, tonic extension intermittently developed in the lower extremities and was controlled with midazolam. Mild elevated blood pressure, tachycardia, tachypnea, high fever (up to 38.5degrees C) and respiratory acidosis occurred. Thirty minutes later, she became mentally clear with a normal neurologic examination. No delayed sequelae were detectable at a follow-up visit 1 month and 1 year after surgery.

Keyword

Accidental intrathecal injection; acetylcysteine

MeSH Terms

Acetylcysteine*
Acidosis, Respiratory
Anesthesia, General
Anesthesia, Spinal
Blood Pressure
Bupivacaine
Female
Fever
Follow-Up Studies
Humans
Lower Extremity
Midazolam
Neurologic Examination
Syndactyly
Tachycardia
Tachypnea
Thiopental
Toes
Upper Extremity
Young Adult
Acetylcysteine
Bupivacaine
Midazolam
Thiopental