Braque S, Bernard-Bertrand F, Guillou N, Guezennec D, Canciani J P, Gentili M E
Centre Hospitalier Privé Saint-Grégoire, 35760 Saint-Grégoire, France.
Acta Anaesthesiol Belg. 2008;59(2):91-4.
Local anesthetics when injected intravascularly result in serious cardiac complications including therapy-resistant cardiac arrest. We report a case of cardiac arrest after lumbar plexus block using a combination of 0.5% bupivacaine and 2% lidocaine with epinephrine (1:200.000). Resuscitation was performed by a combination of chest compression, repeated external countershocks and i.v.epinephrine. Clonidine had poor effect. The whole resuscitation required 90 minutes. The patient was discharged four days later without any sequelae. Blood sampling at 10 minutes showed a concentration of 2.02 mg/l lidocaine and 0.87 mg/l bupivacaine. Prolonged resuscitation is necessary in local anesthetic-induced cardiac arrest.
局部麻醉药血管内注射会导致严重的心脏并发症，包括难治性心脏骤停。我们报告一例在使用0.5%布比卡因和2%利多卡因加肾上腺素（1:200,000）联合进行腰丛阻滞术后发生心脏骤停的病例。通过胸外按压、反复体外除颤和静脉注射肾上腺素进行复苏。可乐定效果不佳。整个复苏过程需要90分钟。患者四天后出院，无任何后遗症。10分钟时采血显示利多卡因浓度为2.02mg/l，布比卡因浓度为0.87mg/l。对于局部麻醉药引起的心脏骤停，延长复苏时间是必要的。
