ACCIDENTAL INTRAMUSCULAR VINCRISTINE - LACK OF UNTOWARD EFFECTS AND RECOMMENDATIONS FOR MANAGEMENT

Vincristine was inadvertently injected into a thigh of three children. In each case the accident occurred as a result of the mixing of a syr inge containing vincristine with a syringe of L-asparaginase which the patient was scheduled to receive on the same day. Within minutes, eac h patient was treated topically with cold compresses and the area was infiltrated with a solution of 8.4% sodium bicarbonate. Only one patie nt had discomfort of the thigh after the injection, none of the patien ts have had any sequelae, either acute or delayed. Measures to avoid m istaken injection of vincristine for asparaginase are readily achievab le and have prevented recurrences of intramuscular vincristine adminis tration at the institutions where they have been implemented. Nonethel ess, other instances of intramuscular vincristine injection are antici pated and should be rapidly recognized and quickly managed with local applications of cold and sodium bicarbonate. (C) 1997 Wiley-Liss, Inc.