ABSTRACT
A 4-year-old boy, weighing 15.6 kg, experienced two episodes of cardiac arrest during the eight sessions of sclerotherapy under general anesthesia. Although cardiac arrest had been documented after accidental extubation during the seventh procedure, the specific cause had not been identified. For the eighth procedure, anesthesia was again induced and maintained with nitrous oxide and sevoflurane. A total of 10 ml of 3% polydocanol was injected. Approximately five minutes after the injection, his heart rate slowed and asystole developed. External cardiac massage was started immediately and atropine was injected intravenously. His heart started to beat again very soon. From the clinical course, the two episodes of cardiac arrest could be attributable to polydocanol overdose. It was concluded that severe circulatory derangement might follow an injection of polydocanol during sclerotherapy.
Subject(s)
Heart Arrest/etiology , Polyethylene Glycols/adverse effects , Sclerosing Solutions/adverse effects , Sclerotherapy/adverse effects , Anesthesia, General , Atropine/administration & dosage , Child, Preschool , Heart Arrest/therapy , Heart Massage , Hemangioma, Cavernous/therapy , Humans , Injections, Intravenous , Male , Polidocanol , RecurrenceABSTRACT
Solid food residues were identified in the pharynx of a 17-month-old infant with a cleft palate at the time of anesthesia induction, although nothing-by-mouth directions for more than four hours had been strictly followed. Preoperative airway management, e.g. gargling and nose blowing, is necessary in patients with a cleft palate even after an appropriate period of fasting because food residues may remain in the nose due to the anatomical abnormality.
