Malignant ventricular dysrhythmias in a patient with isovaleric acidemia receiving general and local anesthesia for suction lipectomy

Journal of Clinical Anesthesia
Guy L WeinbergB K Burton

Abstract

We report the occurrence of severe ventricular arrhythmias in a patient with isovaleric acidemia during general anesthesia for suction lipectomy. The timing of events and character of the ECG changes are most consistent with bupivacaine toxicity after subcutaneous injection of tumescence solution containing this local anesthetic. The patient had previously documented carnitine deficiency, a condition which, we speculate, may lower the threshold for bupivacaine induced cardiotoxicity. We review clinical considerations in isovaleric acidemia and conclude that the use of bupivacaine in these patients probably should be avoided.

References

Nov 2, 1978·The New England Journal of Medicine·R M CohnS Segal
Jan 1, 1976·Pediatric Research·I Krieger, K Tanaka
Mar 1, 1991·Pediatric Neurology·E MayatepekC L Hoppel
Jul 1, 1988·Pediatric Research·M NaglakL Elsas
Jul 1, 1988·The Journal of Pediatrics·G T BerryS Segal
Jan 1, 1987·The Journal of Pediatrics·D S MillingtonF Inoue
Feb 1, 1986·European Journal of Pediatrics·C de SousaD Bradley
Dec 1, 1984·The Journal of Clinical Investigation·C R RoeT P Bohan
Jan 1, 1980·Proceedings of the National Academy of Sciences of the United States of America·W J Rhead, K Tanaka
Dec 1, 1993·Plastic and Reconstructive Surgery·T G Hill

❮ Previous
Next ❯

Citations

Aug 13, 2003·Southern Medical Journal·Jeffrey A Feinstein, Kevin O'Brien
Mar 11, 2010·Regional Anesthesia and Pain Medicine·Kenneth Drasner
Feb 25, 2009·Critical Care Medicine·Jeffrey Brent
Nov 26, 2009·Plastic and Reconstructive Surgery·Colin L FaileyHenry C Hsia
Oct 7, 2010·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Leelach RothschildGuy Weinberg
Dec 29, 2006·Toxicological Reviews·Guy Weinberg
May 31, 2011·Anesthesiology Clinics·Pilar Mercado, Guy L Weinberg
Mar 14, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·K Nouette-GaulainF Sztark
Dec 24, 2014·The Journal of Emergency Medicine·Dazhe CaoAlex Koyfman
Jun 23, 2016·Indian Journal of Anaesthesia·Kalpana Vinod Kelkar, Vaijayanti Nitin Gadre
Dec 22, 2007·Chemico-biological Interactions·Lucas B EdelmanGuy L Weinberg
Sep 5, 2012·Expert Review of Clinical Pharmacology·W Stephen Waring
Jun 1, 2017·Current Opinion in Anaesthesiology·Lotte C G Hoegberg, Sophie Gosselin
Jun 27, 2012·Journal of Intensive Care Medicine·Mehmet S Ozcan, Guy Weinberg
Dec 17, 2016·Anesthesia and Analgesia·Benjamin Kloesel, Robert S Holzman
Feb 26, 2000·Anesthesiology·G L WeinbergC L Hoppel
Jun 3, 2015·Journal of Burn Care & Research : Official Publication of the American Burn Association·Matthew Musielak, John McCall
Jul 7, 2018·Anesthesia and Analgesia·Michelle H Vu, Guy Weinberg
May 30, 2006·Anesthesiology·Guy L Weinberg, Verna Baughman
Jan 23, 2018·Regional Anesthesia and Pain Medicine·Michael R Fettiplace, Guy Weinberg
Jul 18, 2008·Anesthesia and Analgesia·Karen A Robbins, Elias N León-Ruiz
Apr 8, 2006·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Jerry Vockley, Regina Ensenauer
Apr 29, 2009·Acta Anaesthesiologica Scandinavica·M VercauterenS Alahuhta
May 23, 2012·Journal of the American Animal Hospital Association·Amy Kaplan, Megan Whelan
Feb 3, 2015·A & a Case Reports·Humphrey LamThomas Austin
Jul 20, 2012·Critical Care Medicine·Guy L Weinberg
Feb 20, 2018·Journal of the Intensive Care Society·Edward WalterJustin Kirk-Bayley
Aug 14, 2019·Current Anesthesiology Reports·Cindy YeohLuis Tollinche
Jan 16, 2015·Annals of Plastic Surgery·Angie M PaikHenry C Hsia
May 21, 2019·Expert Review of Clinical Pharmacology·Maria Paneta, William Stephen Waring
Aug 21, 2001·Journal of the American Academy of Dermatology·W P ColemanUNKNOWN American Acacemy of Dermatology Guidelines/Outcomes Committee
Jan 13, 2021·Minerva anestesiologica·Simonetta TesoroJurgen C DE Graaff

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.