Low risk of extravasation injury from IV infusion of norepinephrine
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Low risk of extravasation injury from IV infusion of norepinephrine The risk of tissue injury due to accidental extravasation of norepinephrine given as a peripheral infusion during surgery is low, according to a study conducted in the Netherlands. The retrospective cohort study examined adverse-drug events linked to peripheral IV norepinephrine administration given for anaesthesia-induced hypotension in patients undergoing elective surgery. In particular, the study focused on adverse events due to norepinephrine extravasation at the infusion site, such as erythema or tissue injury. The analysis included data from 14 385 patients who underwent surgery between January 2012 and January 2016 at two hospitals in the Netherlands and received peripheral IV norepinephrine in a diluted solution of 20 µg/mL during surgery. Only 5 patients (0.035%) experienced norepinephrine extravasation at the infusion site. The estimated risk was 1–8 events per every 10 000 patients (95% CI 0.011%–0.081%). None of the patients who experienced norepinephrine extravasation required surgical or pharmacological intervention. The dose of norepinephrine administered to these 5 patients ranged from 0.02 to 0.05 µg/kg/min, and the total duration of norepinephrine infusion was a median of 20 minutes. The total median dose of norepinephrine administered was 40 µg. The total amount of norepinephrine that extravasated was estimated at between 33µg and 88µg, corresponding to a volume between 1.67mL and 4mL. The researchers conclude that there is no significant association between the use of peripheral dilute norepinephrine infusions and adverse events related to extravasation. Pancaro C, et al. Risk of Major Complications After Perioperative Norepinephrine Infusion Through Peripheral Intravenous Lines in a Multicenter Study. Anesthesia and 803502825 Analgesia 131: No. 4, Oct 2020. Available from: URL: https://doi.org/10.1213/ANE.0000000000004445
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Reactions 26 Sep 2020 No. 1823
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