Reactions 1239 - 14 Feb 2009

★Ephedrine/epinephrine

Salivary gland enlargement (first report withephedrine) in an elderly patient: case report

An 89-year-old woman developed submandibularsalivary gland swelling after receiving ephedrine andepinephrine [adrenaline] for intraoperative hypotensionwhile undergoing right partial hip replacement.

The woman experienced an episode of severeintraoperative hypotension after receiving intrathecalbupivacaine, and another episode when the cement wasplaced in the medullary canal of her femur. Bothhypotensive episodes were treated with ephedrine 90mg,epinephrine 100µg and normal saline. On postoperativetransfer to an ICU, it was noticed that she had developedbilateral dense and painless submandibular masses [timeto reaction onset not stated].

The woman was treated with oral hydration and massagewith a warm compress. Her masses gradually subsided in5 days, and she was discharged on postoperative day 14.

Author comment: "We speculate that perioperativehypovolemia and the use of vasopressors may have causedthe enlargement of submandibular salivary glands in thiscase."Pirat A, et al. Bilateral submandibular salivary gland swelling following regionalanesthesia for hip replacement. Acta Anaesthesiologica Scandinavica 53: 272, No.2, 2009 - Turkey 801135585

» Editorial comment: A search of AdisBase, Medline,Embase and the WHO Adverse Drug Reactions database didnot reveal any previous case reports of salivary glandenlargement associated with ephedrine.

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Reactions 14 Feb 2009 No. 12390114-9954/10/1239-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved