Injectable epinephrine (Adrenalin) should be used with great care. Rare individuals exist who are extremely sensitive to epinephrine. They will develop acute fulminating pulmonary edema upon injection of small amounts of epinephrine while under general anesthesia. Two case reports are presented. The mechanism of epinephrine-induced pulmonary edema is a decrease in left ventricular compliance. The subsequent rise in left ventricular end-diastolic pressure causes increased pulmonary capillary pressure manifest as acute pulmonary edema.
Woldorf NM, Pastore PN. Extreme Epinephrine Sensitivity With a General Anesthesia. Arch Otolaryngol. 1972;96(3):272–277. doi:https://doi.org/10.1001/archotol.1972.00770090394016
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