Acute ischemia of the hand following intra-arterial oxymetazoline injection.
Acute ischemia of the hand following intra-arterial injection of a drug is an infrequent problem, but it requires urgent medical attention. In this report, a patient injected a nasal decongestant, oxymetazoline hydrochloride (Afrin), into his radial artery. This resulted in severe burning pain, and cyanotic, cold, and pulseless hand, suggestive of acute ischemia. Intra-arterial papaverine, nifedipine, anticoagulation with heparin, prednisone, and stellate ganglion block did not improve the hand circulation. Development of gangrene necessitated a disarticulation at the wrist joint. Diagnosis, complications, and therapeutic measures of acute hand ischemia secondary to intra-arterial drug injection are discussed.
Shukla
P C
PC
Division of Emergency Medicine, University of Mississippi Medical Center, Jackson, USA.
D000208:Acute Disease; D000328:Adult; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000139:chemically induced*; D008297:Male; D010109:Oxymetazoline / Q000008:administration & dosage; D015819:Substance Abuse, Intravenous / Q000150:complications*
D010109:Oxymetazoline