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Journal of Case Reports
Transient Hypotension after Submucosal Infiltration of Xylocaine with Adrenaline Solution during Functional Endoscopic Sinus Surgery
Vikas Sharma, Avaneesh Sandupatla, Sunil Dhole
Department of Cardiac Anesthesia, Fortis Escorts Heart Institute, New Delhi, India.
Corresponding Author:
Dr Vikas Sharma
Received: 28-JUL-2020 Accepted: 03-SEP-2020 Published Online: 25-NOV-2020
DOI: http://dx.doi.org/10.17659/01.2020.0064
Introduction: Xylocaine or normal saline along with 1:2,00,000 adrenaline is commonly used for presurgical infiltration. Local infiltration containing adrenaline often causes cardiovascular side effects which may be variable ranging from tachycardia, hypertension, arrhythmias and hypotension in some cases. Case Report: We report a case of 54 year old female a known case of hypothyroidism, dyslipidemia with current admission diagnosis of deflected nasal septum, bilateral nasal polyposis and chronic sinusitis who underwent Functional Endoscopic Sinus Surgery (FESS) and septoplasty. Preprocedure the surgical site was infiltrated with 1:2,00,000 freshly prepared xylocaine with adrenaline solution. Subsequent to this infiltration patient developed hypotension which was transient in nature and responded to intravenous fluid bolus. Conclusion: The infiltration of xylocaine with adrenaline may lead to ß2 receptor activation leading to skeletal muscle vasodilation and decrease in preload leading to hypotension. This was the most probable attributable cause of transient hypotension in our case although this hypotensive effect is not seen commonly.
Keywords : Hypotension, Lidocaine, Nasal Septum, Saline Solution, Sinusitis.
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