Soonchunhyang Med Sci.  2018 Jun;24(1):105-109. 10.0000/sms.2018.24.1.105.

Epinephrine-Induced Acute Pulmonary Edema during Septoplasty

• Koo BS
• Park JW
• Na HW
• Lee MS
• Cho AN
• Chung YH
• Lee JH

• KMID: 2437779
• DOI: http://doi.org/10.0000/sms.2018.24.1.105

Abstract

Epinephrine is used with lidocaine to provide bloodless surgical field and to prolong the action of local anesthetics. But epinephrine also has many adverse reactions, such as agitation, restlessness, headache, tachycardia, hypertension, and some significantly more dangerous conditions including myocardial ischemia, ventricular arrhythmia, cerebral hemorrhage and pulmonary edema, cardiac arrest, etc. We have experienced epinephrine-induced acute pulmonary edema due to submucosal intranasal application of epinephrine soaked gauze during septoplasty. The patient was successfully treated in intensive care unit with positive pressure ventilation, diuretics, and inotropic support. He was extubated after 5 hours and discharged after 7 days without any complications.

Keyword

Epinephrine; Pulmonary edema; Septoplasty

MeSH Terms

Anesthetics, Local
Arrhythmias, Cardiac
Cerebral Hemorrhage
Dihydroergotamine
Diuretics
Epinephrine
Headache
Heart Arrest
Humans
Hypertension
Intensive Care Units
Lidocaine
Myocardial Ischemia
Positive-Pressure Respiration
Psychomotor Agitation
Pulmonary Edema*
Tachycardia
Anesthetics, Local
Dihydroergotamine
Diuretics
Epinephrine
Lidocaine