Abstract 314: Continuous Intravenous Administration is the Method of Epinephrine Administration Recommended for Treating Anaphylaxis

Abstract

Objective: In general, epinephrine treatment for anaphylaxis involves intravenous bolus administration or intramuscular injection. It is said that intravenous bolus administration has many side effects. Thus it is necessary to exercise caution when using this method. We perform continuous intravenous administration with an initial starting amount of 0.1 μg/kg/min because it can be administered reliably into a blood vessel and it is easy to adjust the dose. In this study, we compared the efficacy and safety of the continuous intravenous administration of epinephrine with those of other administration methods. Methods: The survey period was from April 2005 until March 2013. The patients were those diagnosed with anaphylaxis who were admitted to our hospital`s emergency department, and who were treated with epinephrine. We retrospectively investigated the occurrences of side effects and the course of symptom improvement following administration of epinephrine in two groups: continuous intravenous administration and other. Results: A total of 108 patients were included in the study, 51 in the continuous intravenous administration group and 57 in the other group. SBP was lower in the continuous intravenous administration group than in the other group (88.06 ± 30.04 mmHg vs 98.35 ± 23.78 mmHg, p = 0.006). Otherwise, there were no significant differences in the backgrounds of the two groups. There were zero cases of side effects in the continuous intravenous administration group, and six cases in the other group, and this difference was significant (p = 0.028). Of the patients showing side effects, three received intravenous bolus administration and three received intramuscular administration. There was no significant difference in the time to symptom improvement with treatment from the time of admission. Conclusions: Continuous intravenous administration of epinephrine produced no side effects relating to anaphylaxis, and there was no significant difference in the time to symptom improvement with regard to the method of administering epinephrine.