title: Unintentional epidural injection of 88 μg·kg(-1) of epinephrine.
abstract: We report the effects of 88 μg·kg(-1) of epinephrine (1:10,000) injected into the caudal epidural space of a 42-week postconceptual age infant. No long-term neurological or cardiovascular sequelae occurred. Noninvasive cardiac output (CO) monitoring revealed increased CO, contractility, and stroke volume for about an hour, accompanied by a reduction in peripheral vascular resistance and a modest increase in pulse and blood pressure.
authors.affiliation: Division of Pediatric Anesthesia, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: August
authors.forename: Jinghu
authors.initials: J
authors.lastname: Sui
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Coté
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000767:Anesthesia, Epidural / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007223:Infant; D007268:Injections, Epidural; D008508:Medication Errors; D008991:Monitoring, Physiologic / Q000379:methods; D013610:Tachycardia / Q000139:chemically induced; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000316:Adrenergic alpha-Agonists; D004837:Epinephrine
keywords: adverse events; drug overdose; epinephrine; noninvasive monitors; pharmacodynamics; sacral epidural