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- Title
Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -.
- Authors
Ji Yeon Kim; Beom Il Park; Min Hee Heo; Kyoung Woo Kim; Sang-Il Lee; Kyung-Tae Kim; Won Joo Choe; Jang Su Park; Jun Hyun Kim
- Abstract
Background: Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks. Case: Two patients underwent surgery for radius fractures. We used lidocaine 100 mg and ropivacaine 150 mg for blocking and infused dexmedetomidine for intraoperative sedation. The 63-year-old male patient’s blood pressure dropped to 87/60 mmHg after 3 h 15 min after blocking. Ventricular fibrillation occurred 10 min later. After five defibrillations, electrocardiography showed ventricular tachycardia that was normalized through one cardioversion. The 54-year-old female patient’s heart rate decreased to 35 beats/min 2 h 30 min after blocking. Her vital signs returned to normal after administering atropine, ephedrine, epinephrine, and lipid emulsion. Conclusions: Physicians should remember that LAST may occur long after local anesthetic injection and be aware of factors that may adversely affect the course of LAST.
- Subjects
BRACHIAL plexus block; LIDOCAINE; DRUG side effects; LOCAL anesthesia; ROPIVACAINE
- Publication
Anesthesia & Pain Medicine, 2022, Vol 17, Issue 2, p228
- ISSN
1975-5171
- Publication type
Article
- DOI
10.17085/apm.21093