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Hypoxic brain damage after intramuscular self-injection of diclofenac for acute back pain

Published online by Cambridge University Press:  16 August 2006

W. R. Schäbitz ,
C. Berger ,
M. Knauth ,
H. M. Meinck  and
T. Steiner
W. R. Schäbitz
Affiliation:
Department of Neurology, University of Heidelberg, Germany
C. Berger
Affiliation:
Department of Neurology, University of Heidelberg, Germany
M. Knauth
Affiliation:
Department of Neuroradiology, University of Heidelberg, Germany
H. M. Meinck
Affiliation:
Department of Neurology, University of Heidelberg, Germany
T. Steiner
Affiliation:
Department of Neurology, University of Heidelberg, Germany
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Abstract

We present a case of hypoxic brain damage that occurred after intramuscular injection of diclofenac due to a severe anaphylactic reaction. A 38-year-old nurse treated herself for acute lower back pain with 100 mg diclofenac intramuscularly. Five minutes later, she collapsed and developed coma and respiratory arrest. After cardiopulmonary resuscitation she was transferred to hospital. On admission she was comatose and received controlled ventilation of the lungs. Magnetic resonance imaging and computerized tomography showed signs of hypoxic brain injury and the patient died from central cardiopulmonary failure 7 days later. Intramuscular treatment with non-steroidal anti-inflammatory drugs such as diclofenac has rare but potentially severe side-effects. Therefore, intramuscular injections are inappropriate and should be replaced with oral or rectal treatment, which has similar absorption profiles.

Keywords

anoxiaanti-inflammatory agentsnon-steroidaldiclofenabrain damagechronicbrain injurychronicpainback pain
Type
Clinical Letter
Information
European Journal of Anaesthesiology , Volume 18 , Issue 11 , November 2001 , pp. 763 - 765
Copyright
2001 European Society of Anaesthesiology

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