Late Local Anaesthetic Toxicity After Infraclavicular Block Procedure

İnceöz, Hansa; Tutal, Zehra Baykal; Babayiğit, Münire; Kepek, Akın Yurdal; Horasanlı, Eyüp

doi:10.5152/tjar.2015.50023

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…The patient experienced seizures 1 h after injection of local anesthetics but no cardiovascular system symptoms. İnceöz et al [ 6 ] reported LAST that occurred 7 h after infraclavicular BPB single injection. However, they used bupivacaine and prilocaine, which have longer half-lives than the local anesthetics used in our cases and the total amount of drugs used was also large (0.5% bupivacaine 11.25 ml, 56.25 mg + 2% prilocaine 11.25 ml, 225 mg).…”

Section: Discussionmentioning

confidence: 99%

Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -

et al. 2022

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Background: 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.

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Section: Discussionmentioning

confidence: 99%

Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -

et al. 2022

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“…While toxicity symptoms occur in the first 50 seconds in 50% of cases, it was revealed that 75% of cases had clinical findings of toxicity symptoms within the first five minutes [ 1 ]. The incidence of early-onset local anesthetic toxicity varies from 0.04% to 0.18%, while late-onset toxicity findings are encountered more rarely in the literature [ 5 - 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In situations where the cardiovascular system is affected, it is necessary to begin treatment with IV lipid solutions immediately to increase the success of resuscitation [ 9 ]. Most practitioners may consider administering lipid infusion in order to prevent cardiovascular system involvement in a seizure patient.…”

Section: Discussionmentioning

confidence: 99%

A Case of Late-Onset Local Anesthetic Toxicity Observed as Seizure Activity

Tüzen¹,

Yurtlu²,

Çetinkaya³

et al. 2022

Cureus

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Most of the local anesthetic toxicity cases develop within the first five minutes of peripheral block administration. Late local anesthetic toxicity has been rarely reported in the literature. However, it is an important life-threatening problem that can lead to seizures, hemodynamic collapse, and cardiac arrest if it is ignored and not considered. Here we present the case of an 18-year-old male patient who had ultrasonography-guided infraclavicular brachial plexus block administration with a 30 mL local anesthetic. The patient had convulsions 210 minutes after the block administration and was treated with intravenous diazepam. Intraoperative and postoperative courses were uneventful. He had no neurologic signs or symptoms afterward. All laboratory tests and radiologic investigation tests were normal. This report demonstrates that late local anesthetic toxicity is still possible after several hours of the uneventful peripheral neural blockade, although it is rarely reported.

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“…LAs complications have been reported in a wide range from simple allergic conditions to cardiovascular and neurological complications that can be fatal (3,7). There are also cases that have been successfully treated following the recommendations of the clinical guidelines (8)(9)(10). Protocols for ensuring airway safety, assessment of circulation, and intravenous lipid emulsion (ILE) treatment are included in LAST treatment (3,7).…”

Section: Introductionmentioning

confidence: 99%

Acil Tıp Asistanlarının Lokal Anestetik Sistemik Toksisitesine İlişkin Bilgi Düzeyleri: Kesitsel Bir Çalışma

İlhan

Demir

2020

Konuralp Tıp Dergisi

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Objective: Local anesthetics (LAs) are starting to be used after the discovery of cocaine, which is used in medical practice. Now LAs are used many procedures in many clinics, especially in emergency departments (EDs). The extensive use of LAs was brought side effects and toxicity. Local anesthetic systemic toxicity (LAST) have been reported from simple allergic conditions to cardiovascular and neurological complications that can be fatal. The study aims to evaluate the level of knowledge and awareness of LAST among emergency medicine residents (EMRs). Methods: This was a questionnaire-based cross-sectional study. The questionnaires were sent to EMRs via e-mail, and responses were collected. The participants who gave informed consent included in the study, and who didn't use LAs in their daily practice were excluded. All of the participants responded all of the questions and responses were analyzed. Results: 92 EMRs were included in the study. The median age of the participants was 29 (24-50) years, and 48.9% were women. In the research, no one could recognize all LAST symptoms, ranging from mild to severe. Only 16.3% of the participants answered all treatment options of the LAST correctly, and 27.2% knew the intravenous lipid emulsion dosage accurately. Conclusions: The level of knowledge and awareness of the EMRs on LAST were insufficient. EMRs training rates on LAs and LAST were found to be low. In addition, it was stated that the patient's informed consent was not appropriately obtained from the vast majority of patients undergoing LA procedure. As the first study on LAST among EMRs, we believe that necessary arrangements should be made regarding the detected deficiencies.

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Late Local Anaesthetic Toxicity After Infraclavicular Block Procedure

Cited by 5 publications

References 11 publications

Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -

Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -

A Case of Late-Onset Local Anesthetic Toxicity Observed as Seizure Activity

Acil Tıp Asistanlarının Lokal Anestetik Sistemik Toksisitesine İlişkin Bilgi Düzeyleri: Kesitsel Bir Çalışma

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