title: Successful resuscitation from cardiac arrest associated with extradural lidocaine in a dog.
abstract: BACKGROUND
  Extradural lidocaine exerts several adverse effects which are seldom fatal. While cardiac arrest following extradural lidocaine injection has been reported in human beings, it has not hitherto been reported in dogs.
  
  
  METHODS
  The emergency management of a dog with complete urethral obstruction is described. We intended to perform vaginoscopy and cystostomy under extradural lidocaine anaesthesia, but cardiac asystole occurred a few minutes after injection. Resuscitation was successful. About 20 minutes later cardiac arrest recurred, and was treated successfully. The dog remained hypothermic for approximately 7 hours. Complete recovery without neurological deficit occurred the next day and the dog remained normal for at least 3 months. The probable cause of the problem was cranial lidocaine dispersion causing a drop in cardiac preload and cardiac arrest. The successful neurological outcome was attributed to early diagnosis and effective treatment. Hypothermia may have conferred cerebral protection during ischemia.
  
  
  CONCLUSIONS
  Extradural local anaesthetic administration is not without risk and the technique should be tailored to individual animals. Constant monitoring is required to detect potentially fatal complications and increase the likelihood of successful outcome.
authors.affiliation: Clinic of Surgery, Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, St. Voutyra 11, GR-546 27 Thessaloniki, Greece. isavas@vet.auth.gr
authors.forename: Ioannis
authors.initials: I
authors.lastname: Savvas
authors.forename: Tilemahos
authors.initials: T
authors.lastname: Anagnostou
authors.forename: Lysimachos G
authors.initials: LG
authors.lastname: Papazoglou
authors.forename: Dimitris
authors.initials: D
authors.lastname: Raptopoulos
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects*; D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000662:veterinary*; D004283:Dog Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy*; D004285:Dogs; D005260:Female; D006323:Heart Arrest / Q000628:therapy / Q000662:veterinary*; D007268:Injections, Epidural / Q000662:veterinary; D008012:Lidocaine / Q000009:adverse effects*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine