Local anaesthetic toxicity in a pregnant patient undergoing lignocaine-induced intravenous regional anaesthesia.
A pregnant patient at 38 weeks' gestation developed symptoms of local anaesthetic toxicity following intravenous regional anaesthesia (IVRA) for hand surgery, using a standard dose of lignocaine. Reports suggest that a number of factors, both physiological and pharmacological, combine to increase the likelihood of local anaesthetic (LA) toxicity in pregnancy despite employment of a conventional "safe" IVRA technique. It is suggested that for IVRA, pregnant patients are premedicated with a benzodiazepine, the tourniquet time is increased and the concentration of LA is decreased to reduce the risks of LA toxicity.
Coleman
M
M
Department of Anaesthesia and Intensive Care, Cork University Hospital, Ireland.
Kelly
D J
DJ
D000328:Adult; D000771:Anesthesia, Intravenous; D000779:Anesthetics, Local / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D011247:Pregnancy
D000779:Anesthetics, Local; D008012:Lidocaine