Inadvertent intrathecal injection of atracurium

Abstract

This report relates how tracurium was given by mistake, intrathecally, during spinal anesthesia, to a 38-year-old woman, who was a candidate for abdominal hysterectomy. When no analgesia was observed, the mistake in giving the injection was understood. She was evaluated postoperatively by train of four ratio, measuring her breathing rate, eye opening, and protruding of tongue at one, two, twenty-four, and forty-eight hours, and then at one and two weeks, with the final evaluation the following month. The patient had normal timings during the operation and postoperation periods, and no abnormal findings were observed through the first month. This finding was contrary to several studies, which described adverse reactions due to accidental intrathecal injection of neuromuscular blocking drugs.

Inadvertent Subcutaneous Injection of Atracurium During Circumcision Operation

“…According to the studies, inadvertently intrathecal injection of atracurium causes signs and symptoms such as tachycardia, hypotension, and diplopia (18,19). However, two cases of inadvertently intrathecal injection of atracurium have been reported that did not show hemodynamic symptoms and complications (20,21). According to reports, high-dose intravenous injection of atracurium causes seizure (19).…”

Accidental intrathecal injection of magnesium sulfate for cesarean section

“…One of the challenging problems in the operating room is accidental injection of drugs in epidural and subarachnoid spaces. It can be safe such as labetalol and atracurium[ 1 2 ] to even death following injection of vindesine or[ 3 ] bortezomib. [ 4 ]…”

Awake intubation with succinylcholine via cricothyroid cartilage

“…Inadvertent subarachnoid or subcutaneous injection of nondepolarizing muscle relaxants has been reported. [ 4 ] In a study by Iwasaki et al ., peak effect of pancuronium was much faster in intravenous injection and recovery time was longer after subcutaneous injection. [ 5 ]…”