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[Accidental epidural injection of hypertonic sodium chloride solution]
1Service d'Anesthésie-Réanimation, Clinique Sainte-Anne, Gourin.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1991
Summary
Accidental epidural injection of hypertonic saline caused severe pain, which resolved after epidural lidocaine and distilled water administration. This case highlights potential adverse events and management strategies for unintended epidural drug administration.
Area of Science:
- Anesthesiology
- Neurology
- Pain Management
Background:
- Accidental administration of medications into the epidural space can lead to significant patient harm.
- Hypertonic saline is not intended for epidural administration and its effects are not well-documented.
Observation:
- A 53-year-old male with lumbar backache and sciatica received an accidental 20 ml of 20% hypertonic saline injection into the epidural space.
- The patient subsequently developed severe thoracolumbar pain.
Findings:
- The severe pain resolved after the administration of 20 ml of 1% lidocaine and 40 ml distilled water via the epidural route.
- Three months post-event, the patient's sciatica had significantly improved with no motor deficits.
- Literature review provided explanations for the observed clinical signs.
Implications:
- This case underscores the importance of careful drug preparation and administration to prevent medication errors.
- Prompt recognition and appropriate management, such as epidural lidocaine and saline lavage, can mitigate adverse effects of accidental epidural hypertonic saline injection.
- Further investigation into accidental epidural injections of various substances is warranted to improve patient safety protocols.