Abstract
The Sri Lankan Journal of Anaesthesiology is the official journal of the College of Anaesthesiologists of Sri Lanka. It publishes clinical investigations, research articles, audits, case reports, review articles and CME articles relating to anaesthesiology, critical care and pain. It is published bi annually in January and June. Sri Lankan Journal of Anaesthesiology is included on DOAJ and Scopus.
Highlights
Epinephrine (Adrenaline) is the prototype drug amongst the sympathomimetics
It is added to local anaesthetic solutions to decrease systemic absorption and prolong the duration of action of the anaesthetic. α1 receptor mediated vasoconstriction decreases bleeding at the surgical site.[1]
We report a case with epinephrine toxicity in a patient posted for Tympanoplasty under local anaesthesia and would like to discuss the issues regarding the use of epinephrine as an additive to local anaesthetic mixtures
Summary
Epinephrine (Adrenaline) is the prototype drug amongst the sympathomimetics. It is a potent activator of α adrenergic receptors and activates β1 and β2 receptors. Α1 receptor mediated vasoconstriction decreases bleeding at the surgical site.[1] We report a case with epinephrine toxicity in a patient posted for Tympanoplasty under local anaesthesia and would like to discuss the issues regarding the use of epinephrine as an additive to local anaesthetic mixtures. Preoperative pulse rate and blood pressure were 78 per minute and 118/70mmHg respectively. After a few minutes patient became restless and developed tachycardia (150-160 per minute), blood pressure had risen to 190/110mmHg along with complaints of headache and chest pain. Blood pressure fell down to 140/90mmHg. Headache and chest pain were relieved and the tachycardia settled after half an hour. The surgery was abandoned and patient was shifted to ICU for further management
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