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DOI: 10.1055/s-0043-1770774
Ventricular Tachycardia after Submucosal Infiltration of Lignocaine 2% with Adrenaline in Endoscopic Pituitary Surgery Under Desflurane Anesthesia
Abstract
Infiltrative analgesia of the nasal cavity using a local anesthetic combined with a potent vasopressor like adrenaline is a well-accepted method for transnasal endoscopic approach in neurosurgeries under general anesthesia. The main purpose of vasoconstrictors in transnasal surgery is to cause blanching of mucosa and reducing bleeding. Although it can reduce the systemic absorption and potential systemic toxicity of a local anesthetic, there can be systemic absorption of the vasoconstrictor itself. Desflurane can further potentiate the arrhythmogenicity of lignocaine with adrenaline by causing QTc prolongation. We report a case of transient ventricular tachycardia in a patient following nasal infiltration with lignocaine adrenaline under desflurane anesthesia.
Publikationsverlauf
Artikel online veröffentlicht:
18. Januar 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Bharadwaj D, Mahajan C, Aggarwal R, Prabhakar H, Chaturvedi A. Comparison of bispectral index-guided administration of desflurane and propofol for endoscopic transnasal transsphenoidal resection of pituitary tumors. J Neuroanaesth Crit Care 2020; 7: 19-26
- 2 Bastola P, Bhagat H, Wig J. Comparative evaluation of propofol, sevoflurane and desflurane for neuroanaesthesia: a prospective randomised study in patients undergoing elective supratentorial craniotomy. Indian J Anaesth 2015; 59 (05) 287-294
- 3 Sharma BS, Sawarkar DP, Suri A. Endoscopic pituitary surgery: techniques, tips and tricks, nuances, and complication avoidance. Neurol India 2016; 64 (04) 724-736
- 4 Sveen K. Effect of the addition of a vasoconstrictor to local anesthetic solution on operative and postoperative bleeding, analgesia and wound healing. Int J Oral Surg 1979; 8 (04) 301-306
- 5 Rasheed M, Felix V, Narendrakumar V. Hemostatic and hemodynamic effects of topical administration versus intranasal injection of adrenaline during endoscopic sinus surgery: a prospective observational study. J Head Neck Physicians Surgeons 2021; 9: 123-127
- 6 Atlee III JL, Bosnjak ZJ. Mechanisms for cardiac dysrhythmias during anesthesia. Anesthesiology 1990; 72 (02) 347-374
- 7 Johnston RR, Eger EI II, Wilson C. A comparative interaction of epinephrine with enflurane, isoflurane, and halothane in man. Anesth Analg 1976; 55 (05) 709-712
- 8 Park WK, Kim MH, Ahn DS. et al. Myocardial depressant effects of desflurane: mechanical and electrophysiologic actions in vitro. Anesthesiology 2007; 106 (05) 956-966
- 9 Kazanci D, Unver S, Karadeniz U. et al. A comparison of the effects of desflurane, sevoflurane and propofol on QT, QTc, and P dispersion on ECG. Ann Card Anaesth 2009; 12 (02) 107-112
- 10 Owczuk R, Wujtewicz MA, Sawicka W, Lasek J, Wujtewicz M. The influence of desflurane on QTc interval. Anesth Analg 2005; 101 (02) 419-422