Korean J Crit Care Med.  2009 Apr;24(1):42-46. 10.4266/kjccm.2009.24.1.42.

Topical Epinephrine-soaked Gauze-induced Ventricular Tachycardia during Skin Grafting: A Case Report

• Lee J
• Yang H
• Kim M
• Gill H
• Chung K
• Chung S
• Song J
• Lee S

• KMID: 2228376
• DOI: http://doi.org/10.4266/kjccm.2009.24.1.42

Abstract

Topical epinephrine is useful to reduce bleeding during skin grafting. However, even though a clear operative field is obtained, systemic absorption of topical epinephrine can occur and this may cause severe hypertension, arrhythmias, ventricular tachycardia, myocardial ischemia, pulmonary edema, or cardiac arrest. We managed a case of cardiac arrhythmia during general anesthesia, which was induced by gauze soaked in topical epinephrine used for skin grafting of burn wounds. A 26-year-old woman developed premature ventricular complexes and ventricular tachycardia during surgery when epinephrine-soaked gauze was applied to the skin donor and burn wound sites to control oozing. The patient was resuscitated immediately and within 10 minutes the vital signs had normalized. It is recommended that caution is exercised when epinephrine-soaked gauze is applied to a large area of skin.

Keyword

cardiac arrhythmia; epinephrine-soaked gauze; skin graft

MeSH Terms

Absorption
Adult
Anesthesia, General
Arrhythmias, Cardiac
Burns
Epinephrine
Female
Heart Arrest
Hemorrhage
Humans
Hypertension
Myocardial Ischemia
Pulmonary Edema
Skin
Skin Transplantation
Tachycardia, Ventricular
Tissue Donors
Ventricular Premature Complexes
Vital Signs
Epinephrine