Hyperkalemic cardiac arrest triggered by intravenous lidocaine following axillary brachial plexus block for the creation of an arteriovenous fistula: A case report.
10.4097/kjae.2008.55.6.756
- Author:
Seok Young SONG
1
;
Heung Dong SHIN
;
Kwi Chu SEO
;
Jin Yong CHUNG
;
Woon Seok ROH
;
Bong Il KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu, Daegu, Korea. usno@cu.ac.kr
- Publication Type:Case Report
- Keywords:
arteriovenous fistula;
brachial plexus block;
end-stage renal disease;
hyperkalemia;
lidocaine
- MeSH:
Anesthetics, Local;
Arteriovenous Fistula;
Brachial Plexus;
Cardiopulmonary Resuscitation;
Dietary Sucrose;
Heart;
Heart Arrest;
Humans;
Hyperkalemia;
Kidney Failure, Chronic;
Lidocaine;
Male;
Ventricular Fibrillation;
Ventricular Premature Complexes
- From:Korean Journal of Anesthesiology
2008;55(6):756-760
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Axillary brachial plexus blockade (BPB) is commonly used as an anesthetic method for patients undergoing the creation of an arteriovenous fistula (AVF) during end-stage renal disease (ESRD). Several studies have shown that the combination of intravenous lidocaine and hyperkalemia in ESRD can produce severe conduction disturbance and asystole. Here, we report a case of cardiac arrest in a 41 year old male patient who manifested severe cardiac conduction disturbance during creation of an AVF. Sixty-five minutes after BPB, the intravenous therapeutic doses of lidocaine administered to treat frequent premature ventricular contractions aggravated his heart rhythm and produced a sine wave and ventricular fibrillation. It was assumed that ventricular fibrillation was induced by a combination of local anesthetics administered during BPB and systemic hyperkalemia as a result of the ESRD [ED highlight-please ensure my changes do not alter your intended meaning]. The patient was completely resuscitated 45 minutes after the cardiopulmonary resuscitation and correction of the hyperkalemia.
