Background: Compartment syndrome of the hand is a rare and devastating complication of peripheral intravenous extravasation. With changes in critical care research, vasoactive medications are now more frequently administered through peripheral lines in the acute setting. Methods: We present the case of a patient diagnosed with compartment syndrome of the hand secondary to phenylephrine extravasation in the setting of hypovolemic shock. Results: The use of fasciotomy compartment release and intraoperative phentolamine resulted in significant improvement in tissue perfusion postoperatively. Conclusion: With incraesed incidence of peripherally administered vasoactive medications, the hand surgeon should be aware of potential complications and treatment of compartment syndrome with urgent fasciotomy and phentolamine administration.
PareJRMooreCL. Intravenous infiltration resulting in compartment syndrome: a systematic review. J Patient Saf. 2018;14(2):e6-e8.
2.
OakNRAbramsRA. Compartment syndrome of the hand. Orthop Clin North Am. 2016;47(3):609-616.
3.
CoddingJLVosbikianMMIlyasAM. Acute compartment syndrome of the hand. J Hand Surg Am. 2015;40(6):1213-1216.
4.
Cardenas-GarciaJSchaubKFBelchikovYG, et al. Safety of peripheral intravenous administration of vasoactive medication. J Hosp Med. 2015;10(9):581-585.
5.
DatarSGutierrezESchertzA, et al. Safety of phenylephrine infusion through peripheral intravenous catheter in the neurological intensive care unit. J Intensive Care Med. 2018;33(10):589-592.
6.
LewisTMerchanCAltshulerD, et al. Safety of the peripheral administration of vasopressor agents. J Intensive Care Med. 2019;34(1):26-33.
7.
Van Der RijtRMartin-SmithJDCloverAJ. Reversal of hand peripheral ischaemia due to extravasation of adrenaline during cardiopulmonary resuscitation. J Plast Reconstr Aesthet Surg. 2013;66(9):e260-e263.
8.
ReynoldsPMMacLarenRMuellerSW, et al. Management of extravasation injuries: a focused evaluation of noncytotoxic medications. Pharmacotherapy. 2014;34(6):617-632.
