Pregledni rad
https://doi.org/10.26800/LV-145-supl4-11
Recognition and management of systemic toxicity of local anesthetics
Josipa Glavaš Tahtler
orcid.org/0000-0003-0030-1615
; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinički bolnički centar Osijek
Ana Cicvarić
orcid.org/0000-0001-9674-6859
Tea Vukoja Vukušić
Slavica Kvolik
orcid.org/0000-0002-5244-9585
Tomislav Ištvanić
Damir Flam
Sažetak
Systemic toxicity of local anesthetics (LA) may mimic other comorbid conditions. It may be difficult to differentiate from seizures, hypovolaemia, or heart disease. We present two patients who developed severe cardiotoxicity after LA injection. The first was a vascular patient who had severe hypotension after epidural levobupivacaine mimicking an anaphylactic reaction, which did not respond to repeated epinephrine injections. Another patient experienced cardiac arrest after intravenous lidocaine during arrhythmia treatment in the intensive care unit (ICU). In both cases, the lipid emulsion had a beneficial effect in the treatment of refractory hypotension after LA. The lipid emulsion helped to distinguish cardiotoxicity from an allergic reaction and cardiac decompensation. Despite the possible complications of intralipid therapy, it should be considered early in the treatment of systemic cardiotoxicity of local anesthetics, both in surgical theater and intensive care. Appropriate hemodynamic monitoring can also help in the early detection of cardiotoxic effects of local anesthetic and the evaluation of applied therapies.
Ključne riječi
LOCAL ANESTHETICS; LEVOBUPIVACAINE; LIDOCAINE; CARDIAC TOXICITY; LIPID EMULSION
Hrčak ID:
310269
URI
Datum izdavanja:
20.11.2023.
Posjeta: 252 *