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Korean Journal of Anesthesiology 2009;56(4):462-465.
DOI: https://doi.org/10.4097/kjae.2009.56.4.462   
Acute pulmonary edema after local infiltration of epinephrine during mastoidectomy: A case report.
Young Jin Chang, Sang Kee Min, Ji Young Yoo, Jong Yeop Kim
1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea. kjyeop@ajou.ac.kr
2Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
A mixture of local anesthetic and epinephrine provides hemostasis for ear microsurgery. However, epinephrine has adverse cardiovascular effects, such as arrhythmia, pulmonary edema, and even cardiac arrest. We have experienced catecholamine-induced cardiovascular crisis, with severe hypertension, tachycardia, and acute pulmonary edema, after subcutaneous infiltration with a 2% lidocaine and 1:200,000 epinephrine solution. The patient recovered without any apparent sequelae after intensive care, including diuretics, steroids, and nitroglycerin for the hypertension and pulmonary edema, and a vasopressor for the subsequent hypotension.
Key Words: Epinephrine; Mastoidectomy; Pulmonary edema


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