Epinephrine-induced lactic acidosis in orthognathic surgery: a report of two cases
손희원, 박세훈, 조현오, 신용준, 손장호,
소속 상세정보
손희원 ( Son Hee-Won ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
박세훈 ( Park Se-Hun ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
조현오 ( Cho Hyun-Oh ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
신용준 ( Shin Yong-Joon ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Anesthesiology and Pain Medicine
손장호 ( Son Jang-Ho ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Oral and Maxillofacial Surgery
KMID : 0355620160420050295
Abstract
Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via β2-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.
키워드
Epinephrine; Orthognathic surgery; Local anesthesia; Lactic acidosis; Topical administration
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