Report of two cases

Liu, K.; Chia, Yuan-Yi

doi:10.1111/j.1399-6576.1995.tb04245.x

Cited by 30 publications

(7 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no evidence-based therapy for the physical events triggered by the epidural infusion of potassium (see Table 2 ). The intravenous application of corticosteroids was often performed as in our case to avoid the possible swelling of the spinal cord (see Table 2 ) [ 9 , 13 , 16 , 18 ]. Liu et al additionally infused methylprednisolone 100 mg intradurally [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Acute transient spinal paralysis and cardiac symptoms following an accidental epidural potassium infusion – a case report

2017

View full text Add to dashboard Cite

BackgroundTo describe a case of an accidental epidural potassium infusion leading to an acute transient spinal paralysis and cardiac symptoms and review the literature on that topic.Case presentationWe report the case of an accidental infusion of 900 mg potassium chloride 7.45% (KCl) into the epidural space, which occurred during epidural analgesia in a 74-year-old patient suffering from immobilization due to lumbar back pain as well as from a paralytic Ileus. The event was resulting in vegetative symptoms, such as tachycardia and hypertension accompanied by a motor complete tetraplegia (AIS B) sub C2 with respiratory depression. The endotracheal intubation was necessary.The patient was treated with 40 mg dexamethasone intravenously, as well an epidural lavage with sodium chloride solution 0.9% (NaCl) through the epidural catheter. The neurologic symptoms completely resolved within five days. An elevation of troponin-T values and a reduced left ventricular ejection fraction (LVEF) of 40% accompanied by transient pectanginous pain were documented. An exertional dyspnea remained.ConclusionsA symptom complex with elevated sympathetic nervous system activity up to a stress cardiomyopathy is possible following epidural potassium infusion. Additionally, generalized pain and muscle spasticity evolve and a progressive acute spinal cord injury syndrome can occur within minutes, accompanied by respiratory depression. Treatment consists of early intensive care and the symptomatic therapy of the associated symptoms, leading in most of the reported cases to a good clinical outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute transient spinal paralysis and cardiac symptoms following an accidental epidural potassium infusion – a case report

2017

View full text Add to dashboard Cite

show abstract

“…Reports of permanent neurological deficits and death have also been reported. [34567] do Nascimento et al . had reported unintentional use of 19.1% KCl as diluents.…”

Section: Discussionmentioning

confidence: 99%

“…Both the patients regained motor and sensory functions 14 and 18 h later, respectively, without any sequela. [7]…”

Section: Discussionmentioning

confidence: 99%

“…It took approximately more than 12 h to recover fully. [347] In this case report, we used calcium gluconate and potassium binder along with supportive measures, and the patient recovered completely in 8 h.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Normal saline (NS) is used as diluent for steroid and local anesthetic agent. [2] Inadvertent injection of potassium chloride (KCl) during anesthesia procedures is reported by many anesthesiologists;[345678] however, to the best of our knowledge, it has not been reported by orthopedic surgeons. Here, we report a case of paraplegia that developed after accidental use of KCl instead of NS as diluent along with methylprednisolone and local anesthetic.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Inadvertent injection of potassium chloride instead of sodium chloride during treatment of chronic low back ache with epidural injection leading to paraplegia

Ranjan

Asif

Ahmad

et al. 2016

J Craniovert Jun Spine

View full text Add to dashboard Cite

Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS. He developed severe cramps in the lower limbs, pruritus, and sweating, and finally paraplegia. Electrocardiography and blood showed features suggestive of hyperkalemia. He was given calcium gluconate and potassium chelating agent along with supportive measures. The patient recovered within 8 h. It is concluded that calcium gluconate and potassium chelating agent can be used if accidentally KCl is injected in epidural space.

show abstract

Complications of Catheter Techniques

Rosenberg

2007

Complications of Regional Anesthesia

View full text Add to dashboard Cite

Report of two cases

Cited by 30 publications

References 12 publications

Acute transient spinal paralysis and cardiac symptoms following an accidental epidural potassium infusion – a case report

Acute transient spinal paralysis and cardiac symptoms following an accidental epidural potassium infusion – a case report

Inadvertent injection of potassium chloride instead of sodium chloride during treatment of chronic low back ache with epidural injection leading to paraplegia

Complications of Catheter Techniques

Contact Info

Product

Resources

About