[Cardiotoxic and neurotoxic effects after accidental intravascular bupivacaine administration. Therapy with lidocaine propofol and lipid emulsion].
Accidental intravascular administration of bupivacaine can cause severe neurotoxic and cardiotoxic effects. We report a case of suspected bupivacaine intoxication due to intravascular injection via an epidural catheter and treatment with lidocaine, propofol, and a 20% lipid emulsion resulting in fast resolution of cardiotoxic and neurotoxic effects. Possible mechanisms of action of the medications used are discussed.
Zimmer
C
C
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, Deutschland. christian.zimmer@uk-essen.de
Piepenbrink
K
K
Riest
G
G
Peters
J
J
D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006331:Heart Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D020258:Neurotoxicity Syndromes / Q000188:drug therapy* / Q000209:etiology*; D015742:Propofol / Q000627:therapeutic use*
D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D008012:Lidocaine; D002045:Bupivacaine; D015742:Propofol