CJEM. 1999 Apr;1(1):34-6. doi: 10.1017/s1481803500006990.
A 9-year-old girl accidentally injected her right thumb with an adult dose of epinephrine through an auto-injector syringe, delivering 0.3 mg of 1:1000 epinephrine. This injection caused immediate ischemic changes in the digit. This is the first reported case of accidental self injection by a child of an adult dose of epinephrine and its successful treatment with low-dose phentolamine simultaneously infiltrated directly into the puncture area and along the course of the digital artery. The use of phentolamine as a specific competitive alpha-adrenergic antagonist to epinephrine has been well documented in adults and animal models. This report compares the management of a pediatric case to that of all reported adult cases of accidental subcutaneous epinephrine injections. This case suggests a pattern of infiltration with low-dose phentolamine that may be the most effective form of treatment for this condition in a patient of any age.
一名 9 岁女孩不慎通过自动注射器将成人剂量的肾上腺素注入右手拇指，注射了 0.3 毫克 1:1000 的肾上腺素。这次注射导致指尖立即发生缺血性改变。这是首例儿童意外注射成人剂量肾上腺素的报告，同时采用小剂量酚妥拉明直接浸润穿刺部位和指动脉走行成功治疗。酚妥拉明作为肾上腺素的特异性竞争性α-肾上腺素能拮抗剂，在成人和动物模型中已有充分的记载。本报告将小儿病例的处理与所有报告的成人意外皮下注射肾上腺素的病例进行了比较。该病例提示，对于任何年龄的患者，使用小剂量酚妥拉明浸润可能是这种情况下最有效的治疗方法。
