title: Successful Resuscitation With Intralipid After Marcaine Overdose.
abstract: The authors present the case of a 32-year-old woman who underwent concomitant abdominoplasty and mastopexy. Before discharge from the recovery room, she experienced cardiac arrest and seizures resulting from an accidental overdose of Marcaine, caused by failure of an intramuscular pain pump. The anesthesiologist initiated a rescue protocol with an Intralipid 20% bolus (1.5 mg/kg), followed by continuous intravenous infusion of 0.25 mg/kg for 60 minutes. The Intralipid intervention resulted in a successful outcome. This case emphasizes the importance of ensuring the availability of Intralipid 20% infusion in the operating room. Plastic surgeons who place postoperative pain pumps must be aware of this method of resuscitation and its effectiveness in treating possible cases of local anesthetic overdose or toxicity.
  
  
  METHODS
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authors.affiliation: Gwinnett Medical Center, Duluth, Georgia drwhiteman@southernplasticsurgery.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Whiteman
authors.affiliation: Gwinnett Medical Center, Duluth, Georgia.
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Kushins
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000506:poisoning*; D002045:Bupivacaine / Q000506:poisoning*; D062787:Drug Overdose; D004655:Emulsions / Q000008:administration & dosage; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D010743:Phospholipids / Q000008:administration & dosage*; D012151:Resuscitation / Q000379:methods*; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D013024:Soybean Oil / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D004655:Emulsions; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D002045:Bupivacaine
keywords: Intralipid; Marcaine; abdominoplasty; bupivacaine overdose; complications; mastopexy; pain pump failure