Inadvertent intrathecal dobutamine administration and barbiturate induced nystagmus: A case report
Anesthesia and Pain Medicine
;
: 26-29, 2013.
Artigo
em Inglês
| WPRIM
| ID: wpr-48749
ABSTRACT
Medication errors remain an unsolved problem in medicine. Some factors have been found to contribute to drug errors, and among them, the incorrect administration of drugs is a major factor. In this case report, 2 ml of dobutamine was inadvertently injected intrathecally instead of bupivacaine owing to ampoule confusion during spinal anesthesia, followed by the induction of general anesthesia with sodium thiopental-sevoflurane. It was uneventful during perioperative period, however, nystagmus was observed in post anesthesia care unit (PACU), about 1 h after induction of general anesthesia. There were no other neurologic abnormalities except nystagmus and vital sign were stable during PACU stay. Nystagmus subsided spontaneously and it was confirmed there was no evidence of any central nervous system lesion on imaging study. The patient was discharged 5 days later without any complications.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Sódio
/
Barbitúricos
/
Bupivacaína
/
Sistema Nervoso Central
/
Dobutamina
/
Sinais Vitais
/
Período Perioperatório
/
Anestesia
/
Anestesia Geral
/
Raquianestesia
Limite:
Humanos
Idioma:
Inglês
Revista:
Anesthesia and Pain Medicine
Ano de publicação:
2013
Tipo de documento:
Artigo
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