Safety of subcutaneous adrenaline as prophylaxis against acute adverse reactions to anti-venom serum in snakebite.
OBJECTIVE
To study the safety of low dose subcutaneous adrenaline given as prophylaxis against acute adverse reactions to anti-venom serum (AVS) in patients bitten by snakes.


METHODS
Patients admitted with snakebite envenoming who satisfied inclusion criteria were given 0.25 ml of 1:1000 adrenaline subcutaneously immediately before administration of AVS. They were observed for adverse effects, and pulse and blood pressure (BP) were monitored.


RESULTS
51 patients [35 males, mean age 34.8 years (SD 14)] were included in the study. Adverse reactions to AVS occurred in 15 (29.4%) patients. There was one death from suspected cerebral haemorrhage, and 3 (5.9%) patients developed small haematomas at the subcutaneous injection site. There were no significant changes in mean pulse or BP following administration of subcutaneous adrenaline.


CONCLUSIONS
Low dose subcutaneous adrenaline did not cause significant changes in pulse rate or BP. Although the death was unlikely to be directly related to subcutaneous adrenaline, we suggest further studies on the safety of this prophylactic treatment before its routine use.
Faculty of Medicine, University of Kelaniya, P O Box 6, Ragama.
A S
AS
Dassanayake
P
P
Karunanayake
K T A A
KT
Kasturiratne
M M D
MM
Fonseka
B
B
Wijesiriwardena
S B
SB
Gunatilake
H J
HJ
de Silva
D000322:Adrenergic Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000997:Antivenins / Q000009:adverse effects*; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D011446:Prospective Studies; D012909:Snake Bites / Q000188:drug therapy*
D000322:Adrenergic Agonists; D000997:Antivenins; D004837:Epinephrine