ABSTRACT

Theophylline is an effective dimethylxantine bronchodilator. Serious toxicity might develop because of its narrow therapeutic index. We described a high dose theophylline injection during the induction of the anesthesia in a 2 yearold 14 kg-male patient scheduled for orchiopexy with the indication of undescended testis. Ten milliliter undiluted theophylline (24 mg/mL) had been administered instead of diluted rocuronium (1 mg/mL) during the induction of anesthesia. The patient had tachycardia and temporary hypotension, and treated with lidocaine injection. Remifentanil was infused (1 mcg/kg/min) for analgesia. Blood theophylline level was 30. 7 mcg/mL after 45 minutes of administration. The surgery was completed in two hours and the patient was referred to the intensive care unit for observation. Then blood theophylline level was 27.4 mcg/mL and his cardiac, metabolic and neurological status was uneventful except mild hypokalemia, hyperglycemia and tachycardia in the ICU. The treatment was symptomatic and patient was transported to the pediatic surgery department and sent home after 48 hours without any problem.

Keywords: Teophylline, overdose, anesthesia, child