Pulmonary edema following phenylephrine intranasal spray administration during the induction of general anesthesia in a child.
Topical phenylephrine, an agent used to facilitate nasotracheal intubation and prevent nasal mucosal bleeding, can cause severe hypertension in some patients, secondary to its stimulation of alpha-adrenergic receptors. Moreover, a high incidence of pulmonary edema is found in patients whose phenylephrine administration is followed by treatment with beta-blocking agents. We report a case of acute pulmonary edema in a pediatric patient who developed severe hypertension after the inadvertent administration of a large dose of topical nasal phenylephrine, followed by beta-adrenergic antagonists (esmolol).
Son
Ji-Seon
JS
Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital 634-18, Keumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-712, Korea. sjs6803@hanmail.net
Lee
Sang-Kyi
SK
D000281:Administration, Intranasal; D000293:Adolescent; D000768:Anesthesia, General; D003803:Dentigerous Cyst / Q000601:surgery; D006801:Humans; D008297:Male; D010656:Phenylephrine / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic
D010656:Phenylephrine