Key result
Submucosal lignocaine with epinephrine linked to abrupt, recurrent pulseless VT in a healthy male.
Case Report (n=1)
Submucosal infiltration of lignocaine with epinephrine during nasal surgery can rarely precipitate life-threatening ventricular tachycardia even in healthy young patients.
Alerts to possible ventricular arrhythmias with lignocaine-epinephrine infiltration in septoplasty; leaves open the true incidence and preventive strategies.
A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt pulseless ventricular tachycardia following submucosal infiltration of lignocaine 2% with epinephrine 1: 200,000 combination. Ventricular tachycardia associated with unconsciousness and absent peripheral pulse was transient and easily reverted by precordial thump, but was recurrent. Ventricular tachycardia was replaced by ventricular bigeminy and subsequently by sinus tachycardia.
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Pawar et al. (2009) conducted a case report in Cardiac arrest / Pulseless ventricular tachycardia (n=1). Submucosal infiltration of lignocaine 2% with epinephrine 1:200,000 was evaluated on Pulseless ventricular tachycardia. Submucosal infiltration of lignocaine 2% with epinephrine 1:200,000 during septoplasty in a healthy 26-year-old male induced abrupt, recurrent pulseless ventricular tachycardia.
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