Safety of subcutaneous adrenaline as prophylaxis against acute adverse reactions to anti-venom serum in snakebite

AS Dassanayake, P Karunanayake, KTAA Kasturiratne, MMD Fonseka, B Wijesiriwardena, SB Gunatilake, HJ de Silva

Abstract

Objectives To study the safety of low dose subcutaneous adrenaline given as prophylaxis against acute adverse reactions to anti-venom serum (AVS) in patients bitten by snakes.

Methods Patients admitted with snakebite envenoming who satisfied inclusion criteria were given 0.25 ml of 1:1000 adrenaline subcutaneously immediately before administration of AVS. They were observed for adverse effects, and pulse and blood pressure (BP) were monitored.

Results 51 patients [35 males, mean age 34.8 years (SD 14)] were included in the study. Adverse reactions to AVS occurred in 15 (29.4%) patients. There was one death from suspected cerebral haemorrhage, and 3 (5.9%) patients developed small haematomas at the subcutaneous injection site. There were no significant changes in mean pulse or BP following administration of subcutaneous adrenaline.

Conclusions Low dose subcutaneous adrenaline did not cause significant changes in pulse rate or BP. Although the death was unlikely to be directly related to subcutaneous adrenaline, we suggest further studies on the safety of this prophylactic treatment before its routine use.

(Index words: Pulse rate, blood pressure, subcutaneous haematoma, cerebral haemorrhage)

DOI: http://dx.doi.org/10.4038/cmj.v47i2.3451

CMJ 2002; 47(2): 48-49

Keywords

Pulse rate; blood pressure; subcutaneous haematoma; cerebral haemorrhage
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