title: [Inadvertent injection of succinylcholine as an epidural test dose].
abstract: OBJECTIVE
  Epidural action of neuromuscular blocking agents could be explained under the light of their physicochemical characteristics and epidural space properties. In the literature there are few cases of accidental neuromuscular agent's epidural administration, manifesting mainly with neuromuscular blockade institution or fasciculations.
  
  
  METHODS
  We report a case of accidental succinylcholine administration as an epidural test dose, in a female patient undergoing scheduled laparotomy, under combined general and epidural anesthesia. Approximately 2min after the succinylcholine injection the patient complained for shortness of breath, while mild fasciculations appeared in her trunk and face, managed by immediate general anesthesia institution. With the exception of a relatively longer duration of neuromuscular blockade compared with intravenous administration, no neurological or cardiovascular sequelae or other symptoms of local or systemic toxicity were observed.
  
  
  CONCLUSIONS
  Oral administration of diazepam seems to lessen the adverse effects from accidental epidural administration of succinylcholine. The meticulous and discriminative labeling of syringes, as well as keeping persistent cautions during all anesthesia procedures remains of crucial importance.
authors.affiliation: Aristotle University of Thessaloniki, AHEPA University Hospital, Clinic of Anesthesiology and Intensive Care, Salonica, Grécia. Electronic address: chpour@gmail.com.
authors.forename: Chryssa
authors.initials: C
authors.lastname: Pourzitaki
authors.affiliation: Aristotle University of Thessaloniki, AHEPA University Hospital, Clinic of Anesthesiology and Intensive Care, Salonica, Grécia.
authors.forename: Georgia
authors.initials: G
authors.lastname: Tsaousi
authors.affiliation: Aristotle University of Thessaloniki, AHEPA University Hospital, Clinic of Anesthesiology and Intensive Care, Salonica, Grécia.
authors.forename: Helena
authors.initials: H
authors.lastname: Logotheti
authors.affiliation: Aristotle University of Thessaloniki, AHEPA University Hospital, Clinic of Anesthesiology and Intensive Care, Salonica, Grécia.
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Amaniti
mesh_terms: D000767:Anesthesia, Epidural; D005260:Female; D006801:Humans; D007267:Injections; D008508:Medication Errors; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D013390:Succinylcholine / Q000008:administration & dosage*
chemical_list: D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine
keywords: Accidental; Acidental; Administração epidural; Agentes bloqueadores neuromusculares; Diazepam; Epidural administration; Fasciculations; Fasciculações; Neuromuscular blocking agents; Succinilcolina; Succinylcholine