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Korean Journal of Anesthesiology 2009;56(6):725-728.
DOI: https://doi.org/10.4097/kjae.2009.56.6.725   
Cardiomyopathy after local infiltration or application of epinephrine for plastic surgery under general anesthesia : Two cases report.
Chan Jin Kim, Jin Mo Kim, Young Ho Jang, Young Sup Shin
1Department of Anesthesiology and Pain Medicine, School of Medicine, Keimyung University, Korea. kimjin00@dsmc.or.kr
2Department of Anesthesiology and Pain Medicine, Purun Hospital, Daegu, Korea.
3Department of Anesthesiology and Pain Medicine, Handong University Sunlin Hospital, Pohang, Korea.
Catecholamine-induced cardiomyopathy rarely occurs after local epinephrine infiltration. We experienced two patients with catecholamine induced cardiomyopathies. An 8-yr-old girl was scheduled for closed reduction of a nasal bone fracture. Propofol and rocuronium bromide were used for induction of anesthesia. After induction, lidocaine mixed with epinephrine was infiltrated to the block of supratrochlear and infraorbital nerves. About 10 sec later ventricular tachycardia, hypotension, hypoxemia, and pulmonary edema developed. The other case was a 23-yr-old woman with a nasal bone fracture. Propofol, rocuronium bromide, and fentanyl were used for the induction of anesthesia. After induction, epinephrine-containing wet gauze was packed in the nasal cavity for mucosal shrinkage. About 1 minute later, hypertension, tachycardia, and hypoxemia developed. After each operation, a transthorcic echo-cardiogram revealed hypokynesia of the myocardium.
Key Words: Epinephrine; Nasal bone fracture; Stress induced cardiomyopathy


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