Catecholamine-induced acute myocardial stunning after accidental intra-operative noradrenaline bolus

Anaesth Rep. 2022 Oct 11;10(2):e12187. doi: 10.1002/anr3.12187. eCollection 2022 Jul-Dec.

Abstract

We report a case of catecholamine-induced acute myocardial stunning that occurred in a six-year-old girl. This was triggered by an accidental noradrenaline injection during general anaesthesia for dental surgery. The clinical course was favourable, although cardiac enzymes and echocardiography were significantly altered. The child was discharged home on the second postoperative day, after complete clinical resolution. We emphasise the need to consider shortening the surgical procedure, and to closely monitor patients following a medication error involving vasopressors even in the absence of symptoms. We highlight the importance of a controlled process for storing, identifying, preparing, and handling medications. The identification of weaknesses in the overall process of drug prescription and administration is of utmost importance.

Keywords: accidental noradrenaline injection; cardiac monitoring; catecholamine‐induced acute myocardial stunning; iatrogenic; non‐cardiac surgery; paediatric anaesthesia; takotsubo cardiomyopathy.

Publication types

  • Case Reports