Kaplan Megan I, Lee Justine A, Hovda Lynn R, Brutlag Ahna
Section of Emergency and Critical Care, Department of Clinical Studies, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
J Am Vet Med Assoc. 2011 Feb 15;238(4):507-10. doi: 10.2460/javma.238.4.507.
2 dogs and a cat were inadvertently given penicillin G procaine-penicillin G benzathine IV instead of propofol during induction of anesthesia for routine dental prophylaxis. One dog and the cat required hospitalization because of severe neurologic impairment and cardiopulmonary arrest (cat); the remaining dog did not develop any clinical signs.
In the 2 animals that developed signs consistent with an immediate adverse reaction, clinical signs included muscle tremors, seizures, blindness, vocalization, agitation, and transient loss of vision. Hypothermia, pruritus, hypotension, and cardiac arrest were also documented.
The 2 affected patients responded to treatment with anticonvulsant medications, centrally acting muscle relaxants, sedation, and intensive supportive care including IV fluid administration and oxygen supplementation as needed. Cardiopulmonary cerebral resuscitation was performed successfully in the cat. The dog that did not develop any clinical signs was not treated. The 2 affected patients recovered fully and were discharged from the hospital after 3 to 4 days with no apparent sequelae.
Penicillin G procaine-penicillin G benzathine and propofol are common drugs in veterinary practice and may both be administered to patients undergoing elective procedures. Because of their similar milky white appearance, veterinarians should label syringes and take care to avoid this medication error. There is no specific antidote for penicillin orprocaine toxicosis. Aggressive and immediate treatment is required in patients that develop an adverse reaction to ensure a successful outcome.
2只狗和1只猫在进行常规牙齿预防性麻醉诱导时，被误将普鲁卡因青霉素G-苄星青霉素G静脉注射，而非丙泊酚。1只狗和猫因严重神经功能障碍和心肺骤停（猫）需要住院治疗；另一只狗未出现任何临床症状。
在出现与立即发生的不良反应一致症状的2只动物中，临床症状包括肌肉震颤、癫痫发作、失明、发声、躁动和短暂视力丧失。还记录到体温过低、瘙痒、低血压和心脏骤停。
2例受影响的患者接受了抗惊厥药物、中枢性肌肉松弛剂、镇静治疗以及强化支持治疗，包括静脉输液和按需补充氧气。猫成功进行了心肺脑复苏。未出现任何临床症状的狗未接受治疗。2例受影响的患者完全康复，3至4天后出院，无明显后遗症。
普鲁卡因青霉素G-苄星青霉素G和丙泊酚是兽医实践中的常用药物，均可用于接受择期手术的患者。由于它们外观相似，均为乳白色，兽医应在注射器上贴上标签，并注意避免这种用药错误。青霉素或普鲁卡因中毒没有特效解毒剂。对出现不良反应的患者需要积极立即治疗，以确保取得成功的治疗效果。
