Levobupivacaine-induced seizures and cardiovascular collapse treated with Intralipid.
Lipid emulsion has been used in the successful treatment of local anaesthetic-induced cardiovascular collapse in animals and in two cases of cardiac arrest in humans. Previous reports of levobupivacaine toxicity in humans have been characterised by neurological signs and symptoms, without serious cardiovascular events. We present a case in which presumed intravenous injection of levobupivacaine led to neurological and cardiovascular consequences. This was treated successfully by resuscitation that included intravenous Intralipid infusion.
Foxall
G
G
Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK.
McCahon
R
R
Lamb
J
J
Hardman
J G
JG
Bedforth
N M
NM
D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy; D000077554:Levobupivacaine; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D012640:Seizures / Q000139:chemically induced* / Q000628:therapy
D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D000077554:Levobupivacaine; D002045:Bupivacaine