Digital gangrene induced by inadvertent intra-arterial cocktail injection of anesthetic agents such as pentazocine, promethazine, and atropine: A serious adverse drug experience

Indian J Pharmacol. 2018 Nov-Dec;50(6):354-357. doi: 10.4103/ijp.IJP_131_18.

Abstract

Gangrenous changes in skin due to accidental intra-arterial injection of promethazine and pentazocine have been reported. Accidental intra-arterial injection is most commonly encountered in the antecubital fossa. However, recent reports in the radial and ulnar arteries have also been encountered. We hereby report a serious, preventable adverse drug experience in the form of digital gangrene induced by inadvertent intra-arterial cocktail injection of anesthetic agents such as pentazocine, promethazine, and atropine, which seems to be in the radial artery as the lateral three digits and dorsum of the hand are affected.

Keywords: Anesthetic agents; atropine; digital gangrene; pentazocine; promethazine.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical
  • Anesthetics / administration & dosage*
  • Atropine / administration & dosage
  • Female
  • Fingers / pathology*
  • Fingers / surgery
  • Gangrene / diagnosis
  • Gangrene / etiology*
  • Gangrene / surgery
  • Humans
  • Injections, Intra-Arterial / adverse effects*
  • Medication Errors*
  • Middle Aged
  • Pentazocine / administration & dosage
  • Promethazine / administration & dosage

Substances

  • Anesthetics
  • Atropine
  • Promethazine
  • Pentazocine