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

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 re...

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Bibliographic Details
Main Authors: Schäbitz, Wolf-Rüdiger (Author) , Berger, Christian (Author) , Knauth, Michael (Author) , Meinck, Hans-Michael (Author) , Steiner, Thorsten (Author)
Format: Article (Journal)
Language:English
Published: 2001
In: European journal of anaesthesiology
Year: 2001, Volume: 18, Issue: 11, Pages: 763-765
ISSN:1365-2346
DOI:10.1046/j.1365-2346.2001.00913.x
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1046/j.1365-2346.2001.00913.x
Verlag, lizenzpflichtig, Volltext: https://www.cambridge.org/core/journals/european-journal-of-anaesthesiology/article/abs/hypoxic-brain-damage-after-intramuscular-selfinjection-of-diclofenac-for-acute-back-pain/3E8B1C75CCC298E66F4F26C856F3FAFE
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Author Notes:W.R. Schäbitz, C. Berger, M. Knauth, H.M. Meinck and T. Steiner

MARC

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520 |a 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. 
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