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ANESTHETIC PHARMACOLOGY

Extravasation Injury in the Perioperative Setting

Wolfram Schummer, MD, DEAA, EDIC^*, Claudia Schummer, MD^*, Ole Bayer, MD^*, Andreas Müller, MD, Don Bredle, PhD, and Waheedullah Karzai, MD

Departments of *Anesthesiology and Intensive Care Medicine and Otolaryngology, Friedrich-Schiller University of Jena, Jena, Germany; Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin; and Department of Anesthesia and Intensive Care Medicine, Zentralklinik Bad Berka, Bad Berka, Germany

Address correspondence and reprint requests to Wolfram Schummer, MD, DEAA, EDIC, Clinic for Anesthesiology and Intensive Care Medicine, Friedrich-Schiller University Jena, Erlanger Allee 103, D-07747 Jena, Germany. Address e-mail to cwsm.schummer{at}gmx.de.

Extravasation is an unintentional injection or leakage of fluid in the perivascular or subcutaneous space. Extravasation injury results from a combination of factors, including solution cytotoxicity, osmolality, vasoconstrictor properties, infusion pressure, regional anatomical peculiarities, and other patient factors. We reviewed the hospital files of patients who had sustained a significant extravasation injury in the perioperative setting at two German hospitals. These cases highlight the risk of devastating consequences from extravasation injury. Vasoactive drugs and hyperosmolar and concentrated electrolyte solutions are the predominant vesicants in the perioperative setting. Prompt and appropriate intervention is important for avoiding or minimizing extensive tissue injury.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999