scholarly journals Use of Intravenous Lipid Emulsion to Reverse Central Nervous System Toxicity of an Iatrogenic Local Anesthetic Overdose in a Patient on Peritoneal Dialysis

2013 ◽  
Vol 47 (1) ◽  
pp. 139-139
2021 ◽  
Vol 10 (5) ◽  
pp. 1013
Author(s):  
Daniel Spitzer ◽  
Katharina J. Wenger ◽  
Vanessa Neef ◽  
Iris Divé ◽  
Martin A. Schaller-Paule ◽  
...  

Local anesthetics are commonly administered by nuchal infiltration to provide a temporary interscalene brachial plexus block (ISB) in a surgical setting. Although less commonly reported, local anesthetics can induce central nervous system toxicity. In this case study, we present three patients with acute central nervous system toxicity induced by local anesthetics applied during ISB with emphasis on neurological symptoms, key neuroradiological findings and functional outcome. Medical history, clinical and imaging findings, and outcome of three patients with local anesthetic-induced toxic left hemisphere syndrome during left ISB were analyzed. All patients were admitted to our neurological intensive care unit between November 2016 and September 2019. All three patients presented in poor clinical condition with impaired consciousness and left hemisphere syndrome. Electroencephalography revealed slow wave activity in the affected hemisphere of all patients. Seizure activity with progression to status epilepticus was observed in one patient. In two out of three patients, cortical FLAIR hyperintensities and restricted diffusion in the territory of the left internal carotid artery were observed in magnetic resonance imaging. Assessment of neurological severity scores revealed spontaneous partial reversibility of neurological symptoms. Local anesthetic-induced CNS toxicity during ISB can lead to severe neurological impairment and anatomically variable cerebral lesions.


2015 ◽  
Vol 10 (3) ◽  
pp. 1133-1138 ◽  
Author(s):  
GANGMING WU ◽  
BIN SUN ◽  
LI LIU ◽  
JUN ZHOU ◽  
LIQUN MO ◽  
...  

1992 ◽  
Vol 75 (6) ◽  
pp. 922???928 ◽  
Author(s):  
David A. Spiegel ◽  
Franklin Dexter ◽  
David S. Warner ◽  
Max T. Baker ◽  
Michael M. Todd

1992 ◽  
Vol 77 (Supplement) ◽  
pp. A894
Author(s):  
D. A. Spiegel ◽  
D. B. Warner ◽  
M. T. Baker ◽  
F. Dexter ◽  
M. M. Todd

Sign in / Sign up

Export Citation Format

Share Document