title: [Acute toxic accident following lumbar plexus block with bupivacaine].
abstract: We report the case of a patient who experienced ventricular dysrhythmias and seizure five minutes after the injection of 30 mL of 0.5% bupivacaine with 1:200,000 epinephrine, during a lumbar plexus block performed via the posterior approach described by Winnie. The patient who underwent his total hip arthroplasty was still anaesthetised and under controlled ventilation at the time of bupivacaine administration. Aspiration test performed before injection was negative. Normal cardiac activity and stable haemodynamic condition were restored after one hour of resuscitation including 15 electric shocks and administration of epinephrine (40 mg) and clonidine (300 micrograms). The patient was discharged without neurologic sequelae after four days in the ICU.
authors.affiliation: Service d'anesthésie et réanimation chirurgicale, Hôtel-Dieu, CHU, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Pham-Dang
authors.forename: S
authors.initials: S
authors.lastname: Beaumont
authors.forename: H
authors.initials: H
authors.lastname: Floch
authors.forename: J
authors.initials: J
authors.lastname: Bodin
authors.forename: A
authors.initials: A
authors.lastname: Winer
authors.forename: M
authors.initials: M
authors.lastname: Pinaud
mesh_terms: D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D016887:Cardiopulmonary Resuscitation; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000503:physiopathology; D004837:Epinephrine; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D014662:Vasoconstrictor Agents
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002045:Bupivacaine; D004837:Epinephrine
vernacular_title: Accident aigu toxique après bloc du plexus lombaire à la bupivacaïne.