Korean J Anesthesiol.  2009 Jun;56(6):725-728. 10.4097/kjae.2009.56.6.725.

Cardiomyopathy after local infiltration or application of epinephrine for plastic surgery under general anesthesia : Two cases report

• Kim CJ
• Kim JM
• Jang YH
• Shin YS

• KMID: 2092211
• DOI: http://doi.org/10.4097/kjae.2009.56.6.725

Abstract

Catecholamine-induced cardiomyopathy rarely occurs after local epinephrine infiltration. We experienced two patients with catecholamine induced cardiomyopathies. An 8-yr-old girl was scheduled for closed reduction of a nasal bone fracture. Propofol and rocuronium bromide were used for induction of anesthesia. After induction, lidocaine mixed with epinephrine was infiltrated to the block of supratrochlear and infraorbital nerves. About 10 sec later ventricular tachycardia, hypotension, hypoxemia, and pulmonary edema developed. The other case was a 23-yr-old woman with a nasal bone fracture. Propofol, rocuronium bromide, and fentanyl were used for the induction of anesthesia. After induction, epinephrine-containing wet gauze was packed in the nasal cavity for mucosal shrinkage. About 1 minute later, hypertension, tachycardia, and hypoxemia developed. After each operation, a transthorcic echo-cardiogram revealed hypokynesia of the myocardium.

Keyword

Epinephrine; Nasal bone fracture; Stress induced cardiomyopathy

MeSH Terms

Androstanols
Anesthesia
Anesthesia, General
Anoxia
Cardiomyopathies
Epinephrine
Female
Fentanyl
Humans
Hypertension
Hypotension
Lidocaine
Myocardium
Nasal Bone
Nasal Cavity
Propofol
Pulmonary Edema
Surgery, Plastic
Tachycardia
Tachycardia, Ventricular
Androstanols
Epinephrine
Fentanyl
Lidocaine
Propofol