Failure to inflate the cuff of a tracheal tube

Abstract

Correspondence Priapism and general anaesthesiaRecently the urology journals have shown interest in the medical management of priapism. Successful agents are alpha adrenoceptor agonists, for example metaraminol (1 mg), ephedrine (50 pg), phenylephrine, or dopamine, injected into the corpus cavernosum.'--'We had a case of priapism under general anaesthesia that prevented the urologist from passing the cystoscope. Ten milligrams metaraminol was injected into the corpus by the surgeon. This solved the problem, and the operation was over in 5 minutes. However, the patient developed ventricular tachycardia, that approached a rate of 200 beats/ minute, with an arterial blood pressure of 200/140 mmHg. This settled without treatment and the patient made a full recovery.Two deaths have been reported from the use of metaraminol to treat priapism; both were attributed to arterial hypertension. The development of ventricular tachycardia was potentially serious in this case; the dose was about 10 times that recommended.