Case report: successful prophylactic use of intravenous lipid emulsion to prevent local anesthetic systemic toxicity after inadvert intravenous administration of bupivacaine

Mahrous, Reham; Kareem, Ahmed; Hussam, Ayman M.; Mandour, Omnia A.

doi:TEJA-2021-0087

Case report: successful prophylactic use of intravenous lipid emulsion to prevent local anesthetic systemic toxicity after inadvert intravenous administration of bupivacaine

Authors

TEJA-2021-0087

Abstract

Bupivacaine is a local anesthetic drug that carries catastrophic adverse effects. On exceeding the toxic dose significant cardiotoxic and neurotoxic consequences emerge. The maximal toxic dose of Bupivacaine for local applications is 2 mg.kg-1. The exact hazardous dose for intravenous administration is unknown. Abdominal hysterectomy was scheduled for our 57-year-old patient. She received 20 mg of Bupivacaine intravenously by accident and showed no evidence of cardiac or neurological toxicity. The explanation for this is unknown, although it could be owing to the very low dose, which was less than the toxic amount, or to our patient’s early lipid emulsion prophylaxis.

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