Sympathetic hyperactivity, respiratory failure, pruritus, and anesthesia after unintentional epidural injection of potassium chloride: Case report

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.creatorNascimento Junior, Paulo do-
Autor(es): dc.creatorMódolo, Norma Sueli Pinheiro-
Autor(es): dc.creatorMeletti, José Fernando do Amaral-
Autor(es): dc.creatorBraz, José Reinaldo Cerqueira-
Data de aceite: dc.date.accessioned2025-08-21T19:07:53Z-
Data de disponibilização: dc.date.available2025-08-21T19:07:53Z-
Data de envio: dc.date.issued2014-05-20-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2014-05-20-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued1998-01-01-
Fonte completa do material: dc.identifierhttp://www.sciencedirect.com/science/article/pii/S1098733998800199-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1136/rapm-00115550-199823020-00019-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/250374-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/250374-
Descrição: dc.descriptionBackground and Objectives. A combination of epidural and general anesthesia has been widely used to attenuate the surgical stress response and to provide postoperative analgesia. This case report illustrates the use of this anesthetic technique. Analgesia was induced with local anesthetic in the immediate postoperative period using unintentional 19.1% potassium chloride (KCI) as diluent. Methods. An ASA I male patient was scheduled for surgical correction of idiopathic megaesophagus under continuous epidural anesthesia combined with general anesthesia. In the postoperative period, while preparing 10 mt 0.125% bupivacaine to be administered through the epidural catheter for pain control, 5 mt 19.1% KCI was unintentionally used as diluent, resulting in a 9.55% potassium solution concentration. Results. The patient developed warmness of the lower limbs, tachycardia, hypertension, intense pruritus on the chest, agitation, exacerbation of sensory and motor blocks, and respiratory failure secondary to pulmonary edema, requiring ventilatory support. Total recovery was observed after 24 hours. Conclusions. Epidurally injected potassium leads to severe clinical manifestations caused by autonomic dysfunction, spinal cord irritation, and possible release of histamine. Despite continuous recommendations, ampule misidentification still happens in hospitals, frequently leading to serious accidents.-
Descrição: dc.descriptionFac Med, Dept Anesthesia, Botucatu, SP, Brazil-
Descrição: dc.descriptionDepartment of Anesthesia Faculdade de Medicina de Botucatu, São Paulo-
Descrição: dc.descriptionDepartamento de Anestesiologia, UNESP, Faculdade de Medicina de Botucatu-
Descrição: dc.descriptionDepartment of Anesthesia Faculdade de Medicina de Botucatu, São Paulo-
Formato: dc.format219-222-
Idioma: dc.languageen-
Publicador: dc.publisherChurchill Livingstone Inc Medical Publishers-
Relação: dc.relationRegional Anesthesia and Pain Medicine-
Direitos: dc.rightsinfo:eu-repo/semantics/restrictedAccess-
???dc.source???: dc.sourceWeb of Science-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectCombined epidural and general anesthesia-
Palavras-chave: dc.subjectPotassium chloride-
Palavras-chave: dc.subjectPruritus-
Palavras-chave: dc.subjectRespiratory failure-
Palavras-chave: dc.subjectSympathetic hyperactivity-
Palavras-chave: dc.subjectUnintentional injection-
Título: dc.titleSympathetic hyperactivity, respiratory failure, pruritus, and anesthesia after unintentional epidural injection of potassium chloride: Case report-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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