Successful resuscitation of bupivacaine-induced cardiotoxicity in a neonate

Lin, Erica P.; Aronson, Lori A.

doi:10.1111/j.1460-9592.2010.03406.x

Cited by 38 publications

(27 citation statements)

References 7 publications

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“…The use of lipid infusion in moxidectin toxicity in a puppy has been described, and although it was older (16 weeks of age) it was smaller (3.2 kg compared with 4 kg) than the puppy described in Case 6. Extremes of age are not a barrier to the use of lipid infusion; it has been used in the management of local anaesthetic toxicity in human beings aged two days (Lin and Aronson 2010) to 92 years (Weinberg 2012). …”

Section: Discussionmentioning

confidence: 99%

Lipid infusion in the management of poisoning: a report of 6 canine cases

Bates¹,

Chatterton²,

Robbins³

et al. 2013

Vet Record Case Reports

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Intravenous administration of lipid is a relatively new treatment in the management of toxicity from lipophilic compounds. It is used in human medicine in the treatment of toxicity from lipophilic local anaesthetics and cardiotoxic drugs and can result in dramatic improvement in clinical status. We present six cases of poisoning in dogs successfully treated with lipid infusion after ingestion of ivermectin (3), moxidectin (2) and baclofen (1). The dogs ranged in age from eight weeks to 14 years, and weighed 4–30 kg. Intravenous lipid therapy was started between six and eight hours and 22 hours after ingestion, and all the dogs responded well. In four dogs, there was clinical improvement within one hour; one had improved within two hours and the other within 4.5 hours of lipid administration. The only adverse effect of lipid infusion reported was mild swelling and pain after extravasation in one case which resolved with conservative management. All the dogs were discharged within 24–52 hours after exposure (7–46 hours after the start of lipid administration), and none developed any apparent sequelae.

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Section: Discussionmentioning

confidence: 99%

Lipid infusion in the management of poisoning: a report of 6 canine cases

Bates¹,

Chatterton²,

Robbins³

et al. 2013

Vet Record Case Reports

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“…In speziellen Situationen können (unter Berücksichtigung der empfohlenen LA-Maximaldosis) bis maximal 40 ml appliziert werden. [17,20]. Im einen Fall [17] wurde akzidentell 1%iges Ropivacain anstelle der vorgesehenen 0,2%igen Lösung appliziert, sodass eine 5-fache Überdo-sierung resultierte.…”

Section: Lokalanästhetikumunclassified

“…Im einen Fall [17] wurde akzidentell 1%iges Ropivacain anstelle der vorgesehenen 0,2%igen Lösung appliziert, sodass eine 5-fache Überdo-sierung resultierte. Im anderen Fall [20] wird eine unbemerkte systemische Injektion als Ursache für den Herz-KreislaufKollaps vermutet.…”

Section: Lokalanästhetikumunclassified

Kaudalanästhesie bei Kindern

Mauch

Weiß

2012

Anaesthesist

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Caudal block is a safe procedure commonly used for pediatric perioperative analgesia. Complications are extremely rare but nevertheless local and systemic contraindications must be excluded. Optimal safety and quality result when strict attention is paid to technical details. These are discussed in detail in this review. A local anesthetic (LA) containing epinephrine allows early detection of inadvertent intravascular LA administration; therefore an epinephrine/LA mixture is recommended at least for the test dose. In terms of safety the choice of LA itself is probably of secondary importance. Clonidine as an adjuvant has an excellent risk/benefit profile with minimal side effects. Inadvertent systemic LA intoxication is a rare but potentially fatal complication of regional anesthesia and measures for prevention and early detection are essential. Should circulatory arrest occur, immediate resuscitation following standard guidelines is to be initiated including the use of epinephrine as the first line drug. Intravenous administration of lipid solutions may be beneficial as a secondary adjunct to stabilize hemodynamics but is not an alternative to epinephrine.

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“…Die sonographisch gesteuerte LA-Applikation mag das Risiko zwar reduzieren, kann es jedoch nicht eliminieren [11]. In der Kinderanästhesie werden LA routinemäßig unter Allgemeinanäs-thesie und im Vergleich zu erwachsenen Patienten in höherer Dosierung injiziert.…”

Section: Problemstellung Und Wissenschaftliche Grundlagenunclassified