Recurrence of cardiotoxicity after lipid rescue from bupivacaine-induced cardiac arrest.

Abstract:

:Accidental intravascular administration of bupivacaine during performance of a brachial block precipitated convulsions followed by asystole. The patient was rapidly resuscitated using cardiopulmonary resuscitation, supplemented by 150 mL of 20% lipid emulsion. Nonetheless, cardiac toxicity reappeared 40 min after completion of the lipid emulsion. In the absence of further lipid emulsion, amiodarone and inotropic support were used to treat cardiotoxicity. This case suggests that local anesthetic systemic toxicity may recur after initial lipid rescue. Since recurrence of toxicity may necessitate administration of additional doses of lipid emulsion, a sufficient quantity of lipid emulsion should be available when regional anesthesia is performed.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Marwick PC,Levin AI,Coetzee AR

doi

10.1213/ane.0b013e3181979e17

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

1344-6

issue

4

eissn

0003-2999

issn

1526-7598

pii

108/4/1344

journal_volume

108

pub_type

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