title: Successful but prolonged resuscitation after local anesthetic-induced cardiac arrest: is clonidine effective?
abstract: Local anesthetics when injected intravascularly result in serious cardiac complications including therapy-resistant cardiac arrest. We report a case of cardiac arrest after lumbar plexus block using a combination of 0.5% bupivacaine and 2% lidocaine with epinephrine (1:200.000). Resuscitation was performed by a combination of chest compression, repeated external countershocks and i.v.epinephrine. Clonidine had poor effect. The whole resuscitation required 90 minutes. The patient was discharged four days later without any sequelae. Blood sampling at 10 minutes showed a concentration of 2.02 mg/l lidocaine and 0.87 mg/l bupivacaine. Prolonged resuscitation is necessary in local anesthetic-induced cardiac arrest.
authors.affiliation: Centre Hospitalier Privé Saint-Grégoire, 35760 Saint-Grégoire, France.
authors.forename: S
authors.initials: S
authors.lastname: Braque
authors.forename: F
authors.initials: F
authors.lastname: Bernard-Bertrand
authors.forename: N
authors.initials: N
authors.lastname: Guillou
authors.forename: D
authors.initials: D
authors.lastname: Guezennec
authors.forename: J P
authors.initials: JP
authors.lastname: Canciani
authors.forename: M E
authors.initials: ME
authors.lastname: Gentili
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects / Q000097:blood; D002045:Bupivacaine / Q000009:adverse effects / Q000097:blood; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003000:Clonidine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006323:Heart Arrest / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects / Q000097:blood; D008160:Lumbosacral Plexus; D008297:Male; D009407:Nerve Block / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000316:Adrenergic alpha-Agonists; D000779:Anesthetics, Local; D008012:Lidocaine; D003000:Clonidine; D002045:Bupivacaine