Effect of Localized Surgical Use of Adrenaline on Circulatory Dynamics and Changes in Adrenaline Blood Concentration：A Case Report of Thyroid Surgery

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  • 甲状腺手術野で局所散布したアドレナリンによる循環動態への影響と血中濃度の推移

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Abstract

<p>Adrenaline is widely used to achieve hemostasis and obtain a clear operative field. However, various complications such as arrhythmia and transient tachycardia, high blood pressure, pulmonary edema, and cardiomyopathy have been reported. We developed a hypothesis that application of diluted adrenaline in the thyroidal operative field may cause intraoperative hemodynamic change with high adrenaline blood concentration. Intraoperative blood samples from a patient showed extremely high adrenaline levels which persisted until the end of the surgery. In this case report, we show that the topical use of adrenaline in the surgical field resulted in a persistent and higher than expected adrenaline blood concentration compared to the hemodynamic changes. Adrenaline use in the surgical field should be monitored with caution, especially in patients with vessel rich surgical sites.</p>

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