Summary
We have demonstrated the toxicity of diazepam and the safety of ketamine hydrochloride following intra-arterial injection in an anaesthetized animal model.
The pathogenesis of gangrene following intra-arterial injection of drugs is unclear. Clinical reports and this experiment suggest that it only follows injection of highly membrane-soluble drugs.
Early swelling and disruption of capillary endothelial cells were demonstrated after intra-arterial injection of diazepam and thiopentone. We believe that a theory of pathogenesis based on this finding is consistent not only with our experimental findings, but with knownin vitro effects of membrane soluble drugs on cell membranes and the clinical features following intra-arterial injections in both human subjects and in animals.
Résumé
Les auteurs ont démontré la toxicité du diazepam et la sécurité de l’hydrochlorure de kétamine à la suite d’injection intra-artérielle chez 1’animal anesthésié.
La pathogénèse de la gangrène, provoquée par l’injection intra-artérielle de médicaments, n’est pas clairement définie. Les publications cliniques laissent croire que cette gangrène n’est provoquée que par des médicaments trés solubles dansles membranes.
Le diazepam et le penthotal en injection intra-artérielle ont provoqué un oedème précoce et une rupture des cellules endothéliales des capillaires. Nous croyons qu’une théorie pathogénique fondée sur ces faits est compatible, non seulement avec les résultats de nos expériences, mais aussi avec les observations cliniques, de même qu’avec les effets démontrés in vitro de ces médicaments sur les membranes cellulaires.
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Knill, R.L., Evans, D. Pathogenesis of gangrene following intra-arterial injection of drugs: A new hypothesis. Canad. Anaesth. Soc. J. 22, 637–646 (1975). https://doi.org/10.1007/BF03013310
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DOI: https://doi.org/10.1007/BF03013310