title: Intravenous lipid infusion in the successful resuscitation of local anesthetic-induced cardiovascular collapse after supraclavicular brachial plexus block.
abstract: We describe a case of successful resuscitation with an i.v. lipid infusion of local anesthetic-induced cardiovascular toxicity after supraclavicular brachial plexus block with mepivacaine and bupivacaine. Lipid therapy was initiated after 10 min of unsuccessful resuscitation and resulted in restoration of cardiovascular activity and hemodynamic stability. This case illustrates the utility of i.v. lipid therapy in the treatment of local anesthetic toxicity.
authors.affiliation: Department of Anesthesiology, University of Alabama, School of Medicine, Birmingham, AL, USA. julio@uab.edu
authors.forename: Julio A
authors.initials: JA
authors.lastname: Warren
authors.forename: R Brian
authors.initials: RB
authors.lastname: Thoma
authors.forename: Alexandru
authors.initials: A
authors.lastname: Georgescu
authors.forename: Saurin J
authors.initials: SJ
authors.lastname: Shah
mesh_terms: D000779:Anesthetics, Local / Q000009:adverse effects* / Q000097:blood; D001917:Brachial Plexus; D002045:Bupivacaine / Q000009:adverse effects* / Q000097:blood; D016887:Cardiopulmonary Resuscitation; D004562:Electrocardiography; D004638:Emergency Treatment; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006323:Heart Arrest / Q000139:chemically induced / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000009:adverse effects* / Q000097:blood; D008875:Middle Aged; D009407:Nerve Block; D017410:Practice Guidelines as Topic
chemical_list: D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D008619:Mepivacaine; D002045:Bupivacaine