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KMID : 0356920080550060756
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Korean Journal of Anesthesiology
2008 Volume.55 No. 6 p.756 ~ p.760
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Hyperkalemic cardiac arrest triggered by intravenous lidocaine following axillary brachial plexus block for the creation of an arteriovenous fistula -A case report-
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Song Seok-Young
Kim Bong-Il
Seo Kwi-Chu
Jung Jin-Yong
Rho Woon-Seok
Shin Heung-Dong
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Abstract
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Axillary brachial plexus blockade (BPB) is commonly used as an anesthetic method for patients undergoing the creation of an arteriovenous fistula (AVF) during end-stage renal disease (ESRD). Several studies have shown that the combination of intravenous lidocaine and hyperkalemia in ESRD can produce severe conduction disturbance and asystole. Here, we report a case of cardiac arrest in a 41 year old male patient who manifested severe cardiac conduction disturbance during creation of an AVF. Sixty-five minutes after BPB, the intravenous therapeutic doses of lidocaine administered to treat frequent premature ventricular contractions aggravated his heart rhythm and produced a sine wave and ventricular fibrillation. It was assumed that ventricular fibrillation was induced by a combination of local anesthetics administered during BPB and systemic hyperkalemia as a result of the ESRD [ED highlight-please ensure my changes do not alter your intended meaning]. The patient was completely resuscitated 45 minutes after the cardiopulmonary resuscitation and correction of the hyperkalemia.
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KEYWORD
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arteriovenous fistula, brachial plexus block, end-stage renal disease, hyperkalemia, lidocaine
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