Cardiac arrest and secondary pulmonary oedema following accidental intramucosal injection of naphazoline in an adult

During neurosurgery for hypophysary adenoma under general anaesthesia in a prone position, a 34 year-old-women received accidental 6 ml intramucosal injection of lidocaine with naphazoline. The patient presented a severe bradycardia associated with a major increase in arterial blood pression followed by a brief cardiac arrest. She also presented a prolonged awakening and a pulmonary oedema, which lead to mechanical ventilation. The patient rapidly recovered a normal clinical state. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tons droits reserves.