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Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report.
Rev Esp Anestesiol Reanim (Engl Ed). 2021 12; 68(10):602-606.RE

Abstract

An infusion of 100 cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66 years old man who was scheduled for right hemicolectomy, 48 h after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20 cc of saline was slowly injected, followed for a saline infusion of 20 cc per hour. Neurologic signs were totally reverted some hours later and 24 h after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Schwartzmann A
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Rodríguez A
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
Castromán P
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. Electronic address: pablocastro227@gmail.com.

MeSH

AgedAnalgesia, EpiduralAnesthesia, EpiduralCatheterizationCathetersHumansMalePotassium Chloride

Pub Type(s)

Case Reports

Language

eng

PubMed ID

34840102

Citation

Schwartzmann, A, et al. "Accidental Epidural Catheter Infusion of Potassium Chloride for Postoperative Analgesia: a Case Report." Revista Espanola De Anestesiologia Y Reanimacion, vol. 68, no. 10, 2021, pp. 602-606.
Schwartzmann A, Rodríguez A, Castromán P. Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report. Rev Esp Anestesiol Reanim (Engl Ed). 2021;68(10):602-606.
Schwartzmann, A., Rodríguez, A., & Castromán, P. (2021). Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report. Revista Espanola De Anestesiologia Y Reanimacion, 68(10), 602-606. https://doi.org/10.1016/j.redare.2020.10.010
Schwartzmann A, Rodríguez A, Castromán P. Accidental Epidural Catheter Infusion of Potassium Chloride for Postoperative Analgesia: a Case Report. Rev Esp Anestesiol Reanim (Engl Ed). 2021;68(10):602-606. PubMed PMID: 34840102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accidental epidural catheter infusion of potassium chloride for postoperative analgesia: A case report. AU - Schwartzmann,A, AU - Rodríguez,A, AU - Castromán,P, Y1 - 2021/11/25/ PY - 2020/05/08/received PY - 2020/10/11/accepted PY - 2021/11/30/pubmed PY - 2021/12/29/medline PY - 2021/11/29/entrez KW - Accidental infusion KW - Acute spinal cord injury KW - Catéter epidural KW - Complicaciones KW - Complications KW - Epidural catheter KW - Error de medicación KW - Infusión accidental KW - Lesión espinal aguda KW - Medication mistake KW - Potasio KW - Potassium chloride SP - 602 EP - 606 JF - Revista espanola de anestesiologia y reanimacion JO - Rev Esp Anestesiol Reanim (Engl Ed) VL - 68 IS - 10 N2 - An infusion of 100 cc of 0,2% potassium chloride was accidental performed through a thoracic epidural catheter, inserted to perioperative analgesia, to a 66 years old man who was scheduled for right hemicolectomy, 48 h after surgery. Paresis of upper limbs, flaccid paralysis of lower limbs and a sensitive level at T8 was observed. An epidural lavage with an initial dose of 20 cc of saline was slowly injected, followed for a saline infusion of 20 cc per hour. Neurologic signs were totally reverted some hours later and 24 h after the incident the physical exam was normal. We reviewed the clinical presentation of the complication and its mechanisms, the more frequent clinical evolution, as well as treatment measures and strategies to prevent the incident. SN - 2341-1929 UR - https://www.unboundmedicine.com/medline/citation/34840102/Accidental_epidural_catheter_infusion_of_potassium_chloride_for_postoperative_analgesia:_A_case_report_ DB - PRIME DP - Unbound Medicine ER -