title: Cardiac arrest from local anesthetic toxicity after a field block and transversus abdominis plane block: a consequence of miscommunication between the anesthesiologist and surgeon.
abstract: We report the case of a 25-year-old female scheduled for laparoscopic gynecologic surgery under general anesthesia. At the end of laparoscopy, an intraperitoneal infiltration (ropivacaine 0.75%, 20 mL) was administered by the surgeon without informing the anesthesiologist. After tracheal extubation due to significant postoperative pain, the anesthesiologist performed a bilateral transversus abdominis plane block (ropivacaine 0.75%, 40 mL). A seizure followed by ventricular arrhythmia developed 10 minutes after local anesthetic injection. An infusion of 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. This overdose could have been avoided with better communication between anesthesiologist and surgeon.
authors.affiliation: From the Departments of *Anesthetics and Intensive Care and †Obstetrics and Gynecology Surgery, Rouen University Hospital, Rouen, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Scherrer
authors.forename: Vincent
authors.initials: V
authors.lastname: Compere
authors.forename: Cecile
authors.initials: C
authors.lastname: Loisel
authors.forename: Bertrand
authors.initials: B
authors.lastname: Dureuil