Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -
- Author:
Ji Yeon KIM
1
;
Beom Il PARK
;
Min Hee HEO
;
Kyoung Woo KIM
;
Sang-Il LEE
;
Kyung-Tae KIM
;
Won Joo CHOE
;
Jang Su PARK
;
Jun Hyun KIM
Author Information
- Publication Type:Case Report
- From:Anesthesia and Pain Medicine 2022;17(2):228-234
- CountryRepublic of Korea
- Language:English
- Abstract: Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks. Case: Two patients underwent surgery for radius fractures. We used lidocaine 100 mg and ropivacaine 150 mg for blocking and infused dexmedetomidine for intraoperative sedation. The 63-year-old male patient’s blood pressure dropped to 87/60 mmHg after 3 h 15 min after blocking. Ventricular fibrillation occurred 10 min later. After five defibrillations, electrocardiography showed ventricular tachycardia that was normalized through one cardioversion. The 54-year-old female patient’s heart rate decreased to 35 beats/min 2 h 30 min after blocking. Her vital signs returned to normal after administering atropine, ephedrine, epinephrine, and lipid emulsion. Conclusions: Physicians should remember that LAST may occur long after local anesthetic injection and be aware of factors that may adversely affect the course of LAST.
