Open AccessA case of hypotension after intranasal adrenaline infiltration causing a clinical dilemma during the intraoperative period
Author(s) -
Shyam Bhandari,
Mozammil Shaffi,
Saleema Bano,
Suhail Sarwar Siddiqui,
Jahangir Ahmad
Publication year - 2011
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.76595
Subject(s) - medicine , infiltration (hvac) , anesthesia , preload , hemodynamics , surgery , physics , thermodynamics
Solutions containing adrenaline are widely used for presurgical infiltration. Haemodynamic changes associated with its use are well documented in the literature. Prolonged intraoperative hypotension after subcutaneous infiltration of diluted adrenaline is an uncommon scenario. We believe that our case of the prolonged episode of hypotension was secondary to infiltration of nasal septum with a high concentration of adrenaline. As β2 receptor activation leads to skeletal muscle vasodilation, a decrease in preload may have lead to profound hypotension. Postoperatively, the patient was examined and any autonomic or endocrinological pathology was ruled out.