Korean J Anesthesiol.
2009 Apr;56(4):462-465. 10.4097/kjae.2009.56.4.462.
Acute pulmonary edema after local infiltration of epinephrine during mastoidectomy: A case report
- Affiliations
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- 1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. kjyeop@ajou.ac.kr
- 2Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
- KMID: 2236538
- DOI: http://doi.org/10.4097/kjae.2009.56.4.462
Abstract
- A mixture of local anesthetic and epinephrine provides hemostasis for ear microsurgery. However, epinephrine has adverse cardiovascular effects, such as arrhythmia, pulmonary edema, and even cardiac arrest. We have experienced catecholamine-induced cardiovascular crisis, with severe hypertension, tachycardia, and acute pulmonary edema, after subcutaneous infiltration with a 2% lidocaine and 1:200,000 epinephrine solution. The patient recovered without any apparent sequelae after intensive care, including diuretics, steroids, and nitroglycerin for the hypertension and pulmonary edema, and a vasopressor for the subsequent hypotension.
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