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KMID : 0352120190340010059
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Journal of Kyung Hee University
2019 Volume.34 No. 1 p.59 ~ p.59
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Local Anesthetics Toxicity during Brachial Plexus Block for Total Elbow Replacement Surgery - A Case Report -
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Lee Hyun-Jeong
Hwang Tae-Jun
Kang Hee-Yong
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Abstract
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Brachial plexus block is widely used technique for upper limb surgery. However, systemic toxicity can occur if local anesthetics are injected into the blood vessels or systemically absorbed. We experienced seizures after brachial plexus block. A 72-year-old female patient underwent ultrasound-guided supraclavicular brachial plexus block for left-sided revision total elbow replacement. At 15 minutes after injecting 30 mL of mepivacaine, the patient showed confusion and convulsion in her arms and legs. To minimize systemic toxicity, propofol 30 mg and midazolam 2 mg were administered, mask ventilation was performed, and lipid emulsion was infused at a rate of 0.25 ml/kg/min for 15 minutes intravenously. The operation was postponed and the patient recovered without sequalae after being transferred to intensive care unit. We report our clinical experience with a review of the relevant literature.
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KEYWORD
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Brachial plexus block, Lipid emulsion, Local anesthetics, Seizures, Toxicity
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