title: Cardiac arrest after interscalene brachial plexus block with ropivacaine and lidocaine.
abstract: Serious adverse reactions to ropivacaine and lidocaine are rare. In this report, we describe a case of sudden cardiac arrest after an interscalene brachial plexus block with a mixture of 150 mg of ropivacaine and 360 mg of lidocaine in a previously healthy, 34-year-old, 97-kg man. Severe hypotension occurred after successful resuscitation, necessitating an infusion of epinephrine. The patient developed pulmonary oedema, and was mechanically ventilated for 22 h. He eventually made a good recovery. We conclude that although ropivacaine and lidocaine are often considered relatively safe local anesthetics, serious cardiovascular complications can occur after the use of these drugs.
authors.affiliation: Department of Anaesthesiology, Kuopio University Hospital, Kuopio, Finland. matti.reinikainen@kuh.fi
authors.forename: M
authors.initials: M
authors.lastname: Reinikainen
authors.forename: A
authors.initials: A
authors.lastname: Hedman
authors.forename: O
authors.initials: O
authors.lastname: Pelkonen
authors.forename: E
authors.initials: E
authors.lastname: Ruokonen
mesh_terms: D000328:Adult; D000577:Amides / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001917:Brachial Plexus; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine