Inadvertent Intrathecal Administration of Local Anesthetics Leading to Spinal Paralysis with Lipid Emulsion Rescue

Clinical Practice and Cases in Emergency Medicine
Amit GuptaRuchi Patel

Abstract

Bupivacaine and ropivacaine are local anesthetics frequently used for interscalene nerve blocks, which are generally well tolerated; however, some complications include pneumothorax, Horner syndrome, nerve injury and cardiovascular toxicity from vascular injection. On rare occasions, it may be associated with spinal paralysis. While the treatment is mostly supportive, we report an unusual case of administering intravenous lipid emulsion (ILE) as part of resuscitative efforts to hasten neurological recovery from spinal shock.

References

Jul 1, 1986·British Journal of Anaesthesia·B G Covino
Sep 5, 2006·Pharmaceutical Research·David F Driscoll
Aug 25, 2007·Anesthesia and Analgesia·François-Xavier RosePascal Le Corre
Mar 11, 2010·Regional Anesthesia and Pain Medicine·Joseph M NealGuy L Weinberg
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Apr 15, 2011·Emergency Medicine Australasia : EMA·Grant CaveAndis Graudins
Oct 13, 2011·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Ann-Jeannette GeibUNKNOWN Toxicology Investigators’ Consortium (ToxIC)
May 11, 2013·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Michael R ChristianMark B Mycyk
Oct 11, 2013·British Journal of Anaesthesia·R M Mostafa, A Mejadi
Dec 18, 2013·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Michael LevineAnthony F Pizon

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BETA
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