Propofol extravasation and tissue necrosis

Basak, Prasanta; Poste, Jennifer; Jesmajian, Stephen

doi:10.4103/0019-5154.92692

Cited by 11 publications

(13 citation statements)

References 5 publications

(8 reference statements)

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“…[10,11] However other clinical reports and animal studies have shown that propofol extravasation does not cause serious clinical consequences. [11][12][13][14] The above does not usually lead to tissue necrosis due to the favorable chemical properties, including a neutral pH and is otonicity of propofol. [15] In our case we followed up our patient for fifteen days only to find that he did not show any signs of tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Devi¹,

Balasubramanyam²,

Omkarappa³

et al. 2014

jemds

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Section: Discussionmentioning

confidence: 99%

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Devi¹,

Balasubramanyam²,

Omkarappa³

et al. 2014

jemds

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“…LeBlanc et al 12 and Basak et al 13 both reported incidents of propofol extravasation in patients who had required intubation. In both these cases, soft tissue necrosis occurred and in one case, surgical debridement was required.…”

Section: Discussionmentioning

confidence: 99%

Propofol extravasation: a rare cause of compartment syndrome

Kalraiya

Madanipour²,

Colaco³

et al. 2015

BMJ Case Reports

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We detail a rare cause of forearm compartment syndrome that occurred in an 18-year-old patient who presented with a Glasgow Coma Scale of 13/15 after a mixed drug overdose and subsequently required intubation. She suffered extravasation of her propofol infusion, which resulted in intrinsic compression within her forearm muscle compartments. Fortunately, the diagnosis of compartment syndrome was made swiftly and the patient was taken to theatre within 3 h where she underwent an emergency forearm fasciotomy. She made an uneventful recovery and at follow-up her wounds had healed well with no associated morbidity or loss of function. The learning points of this study highlight the importance of thoroughly understanding the signs and symptoms of compartment syndrome while maintaining a high index of suspicion. In addition to a thorough history and examination, consideration of the potential underlying causes allows for a swifter diagnosis and a quicker transition to theatre.

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“…It is well known that thiopental can act as a vesicant [7] and propofol can act as an irritant [8] , [9] , [10] , [11] . However, few reports have shown the vesicant effects of propofol [12] , [13] , [14] . Thus, the risk of skin lesions induced by propofol extravasation is understood incompletely because data are limited to a few case reports.…”

Section: Introductionmentioning

confidence: 99%

Injury due to extravasation of thiopental and propofol: Risks/effects of local cooling/warming in rats

Shibata

Yokooji

Itamura

et al. 2016

Biochemistry and Biophysics Reports

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Inadvertent leakage of medications with vesicant properties can cause severe necrosis in tissue, which can have devastating long-term consequences. The aim of this study was to evaluate the extent of extravasation injury induced by thiopental and propofol, and the effects of cooling or warming of local tissue on extravasation injury at macroscopic and histopathologic levels. Rats were administered intradermally thiopental (2.5 mg/100 µL) or propofol (1.0 mg/100 µL). Rats were assigned randomly to three groups: control (no treatment), cooling and warming. Local cooling (18–20 °C) or warming (40–42 °C) was applied for 3 h immediately after agent injection. Lesion sizes (erythema, induration, ulceration, necrosis) were monitored after agent injection. Histopathology was evaluated in skin biopsies taken 24 h after agent injection. Thiopental injection induced severe skin injury with necrosis. Peak lesions developed within 24 h and healed gradually 18–27 days after extravasation. Propofol induced inflammation but no ulceration, and lesions healed within 1–2 days. Local cooling reduced thiopental- and propofol-induced extravasation injuries but warming strongly exacerbated the skin lesions (e.g., degeneration, necrosis) induced by extravasation of thiopental and propofol. Thiopental can be classified as a “vesicant” that causes tissue necrosis and propofol can be classified as an “irritant”. Local cooling protects (at least in part) against skin disorders induced by thiopental and propofol, whereas warming is harmful.

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Propofol extravasation and tissue necrosis

Cited by 11 publications

References 5 publications

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Accidental Subcutaneous Injection of Vecuronium Bromide in a Patient With Burns

Propofol extravasation: a rare cause of compartment syndrome

Injury due to extravasation of thiopental and propofol: Risks/effects of local cooling/warming in rats

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