Remifentanil
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Respiratory insufficiency following inadvertent epidural administration: case report A 60-year-old man undergoing cholecystectomy experienced respiratory insufficiency after remifentanil was accidentally added to a solution for epidural anaesthesia. The man received local anaesthesia via a T8-T9 epidural catheter. However, instead of tetracaine, remifentanil (1mg in 30mL) was inadvertently added to the lidocaine and epinephrine [adrenaline]-containing anaesthetic solution during its preparation. After an initial 5mL dose containing remifentanil 167µg, two additional 6mL doses of the anaesthetic mixture were administered at 5-minute intervals (total remifentanil dose 567µg). He reported slight lightheadedness after receiving the first dose and, after the third dose, his haemoglobin oxygen saturation (SpO2) decreased to 36%; he became unconscious and rigidity of his chest and abdominal muscles was noted. Mask ventilation was initiated and the man’s SpO2 increased to 76%; after additional administration of IV propofol and vecuronium bromide, his SpO2 reached 100%. He was intubated and underwent surgery under general anaesthesia. He did not experience neurological sequelae. Xu X, et al. Respiratory depression and difficult ventilation after inadvertent epidural administration of remifentanil. Anesthesia and Analgesia 104: 1004, No. 801073252 4, Apr 2007 - China
0114-9954/10/1150-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 5 May 2007 No. 1150
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