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

Dassanayake, A S; Karunanayake, P; Kasturiratne, K T A A; Fonseka, M M D; Wijesiriwardena, B; Gunatilake, S B; de Silva, H J

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

Date

2002-06-27

Authors

Dassanayake, A S

Karunanayake, P

Kasturiratne, K T A A

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.

Description

The Ceylon Medical Journal.

Citation

Dassanayake AS, Karunanayake P, Kasturiratne KT, Fonseka MM, Wijesiriwardena B, Gunatilake SB, de Silva HJ. Safety of subcutaneous adrenaline as prophylaxis against acute adverse reactions to anti-venom serum in snakebite. The Ceylon Medical Journal. 2002 Jun; 47(2): 48-9