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Accidental benzalkonium chloride (zephiran) injection.

Erdem Kilic1, Nilay Er, Alper Alkan

  • 1Erciyes University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kayseri, Turkey. ekilic@erciyes.edu.tr

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|October 22, 2011
PubMed
Summary

An accidental injection of benzalkonium chloride during tooth extraction caused severe swelling and respiratory distress. Prompt medical care and debridement led to an uneventful recovery, highlighting the importance of correct medication administration.

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Area of Science:

  • Dentistry
  • Emergency Medicine
  • Toxicology

Background:

  • Accidental injection of chemicals during dental procedures can lead to severe complications.
  • Benzalkonium chloride is a quaternary ammonium compound used as a disinfectant and preservative.
  • Local anesthetics are routinely used in dental extractions to prevent pain.

Observation:

  • A patient undergoing tooth extraction received an accidental injection of benzalkonium chloride instead of a local anesthetic.
  • The patient rapidly developed chin and neck swelling, dyspnea, and lost consciousness.
  • Immediate transfer to an emergency clinic was required.

Findings:

  • Medical treatment over 20 days was administered for the adverse reaction.
  • Necrotic tissue was debrided, followed by a gingival sulcoplasty procedure.
  • The patient experienced an uneventful recovery after the interventions.

Implications:

  • This case underscores the critical need for meticulous attention to medication accuracy in dental practice.
  • Accidental benzalkonium chloride injection can cause life-threatening airway compromise.
  • Prompt emergency medical intervention and surgical management are crucial for favorable outcomes in such incidents.