{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:35:36Z","timestamp":1791484536491,"version":"4.3.4"},"reference-count":26,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,4]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>Several factors have been identified as contributing to medication administration errors, including look-alike, sound-alike (LASA) errors. LASA errors are important causes of serious adverse events arising from spinal injection of tranexamic acid, which can be confused with ampoules of local anaesthesia.<\/jats:p>\n               <jats:p>We present a case of accidental injection of 250\u2009mg of tranexamic acid rather than prilocaine during spinal anaesthesia. The patient developed lower extremities myoclonus, followed by generalised convulsions and ventricular fibrillation, that was reverted within 6\u2009min. Severe cardiogenic shock requiring both inotropic and vasopressor therapy followed, along with a classic apical ballooning pattern on echocardiography and elevated myocardial injury markers, indicating Takotsubo cardiomyopathy. The patient\u2019s condition progressively improved to full recovery, and she was discharged from hospital after 1\u2009month with no neurological deficit or cardiac dysfunction.<\/jats:p>\n               <jats:p>To our knowledge, this is the 28th reported case of accidental spinal injection of tranexamic acid. We present a brief review of previously published cases.<\/jats:p>","DOI":"10.1136\/bcr-2022-251814","type":"journal-article","created":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T22:00:25Z","timestamp":1689717625000},"page":"e251814","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Polymyoclonus, ventricular fibrillation and Takotsubo after accidental spinal injection of tranexamic acid"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-7608","authenticated-orcid":false,"given":"Laura","family":"Costa","sequence":"first","affiliation":[{"name":"Intensive Care Medicine, Hospital of Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Costa","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Hospital of Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Martins","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Hospital of Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Castro","sequence":"additional","affiliation":[{"name":"Intensive Care Medicine, Hospital of Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"2025082801231505000_16.7.e251814.1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1287"},{"key":"2025082801231505000_16.7.e251814.2","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1213\/ANE.0000000000000938","article-title":"Obstetric neuraxial drug administration errors: a quantitative and qualitative analytical review","volume":"121","author":"Patel","year":"2015","journal-title":"Anesth 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