Introduction: Intralipid therapy is recommended for patients with local anesthetics like Bupivacaine, but it is not advisable for patients with short acting local anesthetic toxicity like Lidocaine. Presentation of case: 42 years old healthy female was brought to Operating room for release of carpel tunnel syndrome of left hand. It was decided to perform Bier block. After placement of successful Bier block, surgery was completed in twenty minutes and after tourniquet release, pt. noted to have shaking movement. Local anesthetic toxicity was suspected as the tourniquet was released too soon, before the recommended time of forty fi ve minutes. ACLS protocol was initiated providing oxygen to patient and providing assistance on breathing and taking care of airway. Patient initially was confused and agitated. But recovered after few minutes and very soon became awake and alert. She was kept on observation for few hours before being discharged. The question was, could intralipid therapy would have been helpful in patients with lidocaine toxicity.
Conclusion: Intralipid therapy may be benefi cial if long acting local anesthetics like Bupivacaine was being used. Bupivacain is also cardio toxic and has a long duration of action. For short acting local anesthetics or local anesthetic’s which are less cardio toxic,following ACLS protocol with symptomatic support may be suffi cient for successful resuscitation.
Historical facts: The Bier Block was fi rst introduced by August Bier in 1908 but C. McK. Holmes reintroduced it in 1963.Today, the technique is common as it is economical, it has a rapid recovery, it is
reliable and is simple to use.Intravenous regional anesthesia or Bier block anesthesia is an anesthetic technique for surgical procedures on the body’s extremities especially the upper extremity where a local anesthetic is injected intravenously. The technique usually involves exsanguination which forces blood out of the extremity,followed be the application of pneumatic tourniquets to safely stop blood fl ow. The anesthetic agent is introduced into the limb and allowed to set in while tourniquets retain the agent within the desired area. After some time, the tourniquet is depressurized to start back the circulation.
Keywords:
Published on: Feb 10, 2017 Pages: 4-6
Full Text PDF
Full Text HTML
DOI: 10.17352/ojpm.000002
CrossMark
Publons
Harvard Library HOLLIS
Search IT
Semantic Scholar
Get Citation
Base Search
Scilit
OAI-PMH
ResearchGate
Academic Microsoft
GrowKudos
Universite de Paris
UW Libraries
SJSU King Library
SJSU King Library
NUS Library
McGill
DET KGL BIBLiOTEK
JCU Discovery
Universidad De Lima
WorldCat
VU on WorldCat
PTZ: We're glad you're here. Please click "create a new query" if you are a new visitor to our website and need further information from us.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."