Ventricular Tachycardia after Submucosal Infiltration of Lignocaine 2% with Adrenaline in Endoscopic Pituitary Surgery Under Desflurane Anesthesia

Abstract

Infiltrative analgesia of the nasal cavity using a local anesthetic combined with a potent vasopressor like adrenaline is a well-accepted method for transnasal endoscopic approach in neurosurgeries under general anesthesia. The main purpose of vasoconstrictors in transnasal surgery is to cause blanching of mucosa and reducing bleeding. Although it can reduce the systemic absorption and potential systemic toxicity of a local anesthetic, there can be systemic absorption of the vasoconstrictor itself. Desflurane can further potentiate the arrhythmogenicity of lignocaine with adrenaline by causing QTc prolongation. We report a case of transient ventricular tachycardia in a patient following nasal infiltration with lignocaine adrenaline under desflurane anesthesia.

Keywords

• prolonged QTc
• desflurane
• adrenaline
• infiltration
• transnasal surgery