Gangrene of the hand following intra-arterial injection.

THE INTRA-ARTERIAL injection of medications in the upper limb may result in serious impairment or loss of part of the extremity. When one reflects on the frequency and casualness with which medications are injected intravascularly into various parts of the upper limb, it is remarkable that there should be so few untoward incidents reported. The textbooks of pharmacology and anesthesiology comment to a varying degree on the complications associated with the intra-arterial injection of drugs. With the exception of thiopental sodium1-7and contrast media, there is little in the medical journals concerning these complications. A number of other compounds have been incriminated; for example, promazine HCl,8chlorpromazine HCl,9ether,10and mephenesin (Myanesin).11A number of reports attribute arterial thrombosis and gangrene to idiosyncrasy or local irritation.8,9,12,13It is more likely that these cases reflect the intraarterial injection of the drug. Reported here are three

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[14]  Hazlett Jw.  The superficial ulnar artery with reference to accidental intra-arterial injection. , 1949 .

[15]  Bellet.  Gangrene following intra-arterial injection of myanesin: Ogilvie, T. A., Penfold, J. B., and Clendon, D. R. T.: Lancet 254:947 (June 19), 1948 , 1949 .

[16]  S. M. Cohen.  Accidental intra-arterial injection of drugs. , 1948, Lancet.