Transient Hypertension, Cardiac Arrhythmia and Prolonged ST-depression due to High Concentration Epinephrine-soaked Gauze Application during Whole Face Resurfacing for Acne Scar with Erbium-Yag Laser : A case report

Park, Chan Do; Kang, Jin Gu; Lee, Byung Dal

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2007;2(2):67-69.
Published online April 30, 2007.

Transient Hypertension, Cardiac Arrhythmia and Prolonged ST-depression due to High Concentration Epinephrine-soaked Gauze Application during Whole Face Resurfacing for Acne Scar with Erbium-Yag Laser : A case report

Chan Do Park, Jin Gu Kang, Byung Dal Lee

Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea. jg1229kr@yahoo.co.kr

Abstract

Subcutaneous and topical epinephrine are widely used for hemostasis during dermatologic procedure. There was substantial variation in the amount of systemic absorption on the basis of patient's general condition, blood supply of wounds. Increased or unpredictable absorption after topical administration may increase anesthetic and cardiovascular risks. There have been no reports about cardiovascular complications developed during laser resurfacing. We experienced a case of transient hypertension, cardiac arrhythmia and ST-depression during whole face resurfacing by Erbium-Yag laser due to application of high concentration epinephrine gauze on the face. The hypertension and arrhythmia were normalized in 2 minutes, and ST-depression was sustained for about 4 hours.

Key Words: arrhythmia, hypertension, laser, resurfacing, ST-depression