CASE REPORT
Year : 2014  |  Volume : 8  |  Issue : 4  |  Page : 562-564

Accidental intrathecal injection of magnesium sulfate for cesarean section


1 Department of Anesthesia, Cardiac Anesthesia Research Center, Imam-Reza Hospital, Mashhad, Iran
2 Department of Anesthesia, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran

Correspondence Address:
Dr. Majid Razavi
Department of Anesthesia, Imam-Reza Hospital, Bahar Street, Mashhad
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-354X.140906

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Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution) was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF) reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.


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