Title: Successful resuscitation from bupivacaine-induced cardiovascular collapse with intravenous lipid emulsion following femoral nerve block in an emergency department.
Authors: Harvey, Martyn; Cave, Grant; Chanwai, Giles; Nicholson, Tonia
Abstract: We report a case of a 69-year-old woman with femoral neck fracture undergoing bupivacaine femoral nerve block for preoperative analgesia in an ED. Seizure and cardiovascular collapse developed immediately after instillation of local anaesthetic. Resuscitation including 20% lipid emulsion was successful in achieving normalization of haemodynamic parameters and ECG QRS duration. No adverse sequelae of lipid administration were observed. We recommend the immediate availability of lipid emulsion in emergency room settings where local anaesthetics are used.
Subjects: CARDIAC arrest; SEIZURES (Medicine); DRUG toxicity; ELECTROCARDIOGRAPHY; HOSPITAL emergency services; INTRAVENOUS fat emulsions; INTRAVENOUS therapy; LOCAL anesthetics; NERVE block; RESUSCITATION; SPASMS; DRUG dosage; THERAPEUTICS
Publication: Emergency Medicine Australasia, 2011, Vol 23, Issue 2, p209
ISSN: 1742-6731
Publication type: Academic Journal
DOI: 10.1111/j.1742-6723.2011.01401.x

Successful resuscitation from bupivacaine-induced cardiovascular collapse with intravenous lipid emulsion following femoral nerve block in an emergency department.

Harvey, Martyn; Cave, Grant; Chanwai, Giles; Nicholson, Tonia