Accidental epidural injection of vecuronium.

IMPLICATIONS We report a case of accidental epidural injection of vecuronium in a female patient who underwent hemorrhoidectomy using epidural anesthesia. Because epidural injection of muscle relaxants may have serious side effects, immediate establishment of airway protection, monitoring of muscle relaxation, and follow-up for clinical signs of neurotoxicity are recommended.

[1]  S. Hoka,et al.  Epidural saline solution prior to local anaesthetic produces differential nerve block , 1998, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[2]  Manohar Sharma,et al.  Bioavailability of Intramuscular Rocuronium in Infants and Children , 1997, Anesthesiology.

[3]  H. Tsukagoshi,et al.  Factors affecting neostigmine reversal of vecuronium block during sevoflurane anaesthesia , 1997, Anaesthesia.

[4]  F. Berry Intramuscular rocuronium in infants and children--is there a need? , 1996, Anesthesiology.

[5]  A. Luks,et al.  Intramuscular Rocuronium in Infants and Children: Dose‐ranging and Tracheal Intubating Conditions , 1996, Anesthesiology.

[6]  H. Tsukagoshi,et al.  Inadequate Antagonism of Vecuronium-Induced Neuromuscular Block by Neostigmine During Sevoflurane or Isoflurane Anesthesia , 1995, Anesthesia and analgesia.

[7]  R. Miller,et al.  The pharmacodynamics and pharmacokinetics of the metabolite 3-desacetylvecuronium (ORG 7268) and its parent compound, vecuronium, in human volunteers. , 1994, The Journal of pharmacology and experimental therapeutics.

[8]  P. Bickler,et al.  Activation of Brain Acetylcholine Receptors by Neuromuscular Blocking Drugs: A Possible Mechanism of Neurotoxicity , 1994, Anesthesiology.

[9]  I. Rampil,et al.  Central Nervous System Effects of Intrathecal Muscle Relaxants in Rats , 1993, Anesthesia and analgesia.

[10]  S Gilman,et al.  Altered excitatory and inhibitory amino acid receptor binding in hippocampus of patients with temporal lobe epilepsy , 1991, Annals of neurology.

[11]  J. Engel,et al.  The Hans Berger lecture. Functional explorations of the human epileptic brain and their therapeutic implications. , 1990, Electroencephalography and clinical neurophysiology.

[12]  R. Lefebvre,et al.  Neostigmine antagonism of vecuronium paralysis during fentanyl, halothane, isoflurane, and enflurane anesthesia. , 1987, Anesthesiology.

[13]  T. Vree,et al.  Convulsive effects and pharmacokinetics of laudanosine in the rat. , 1986, European journal of anaesthesiology.