Tüzen Ahmet Salih, Arslan Yurtlu Derya, Çetinkaya Ahmet Said, Aksun Murat, Karahan Nagihan
Department of Anesthesiology and Reanimation, Izmir Katip Celebi University Atatürk Training and Research Hospital, Izmir, TUR.
Cureus. 2022 Jun 4;14(6):e25649. doi: 10.7759/cureus.25649. eCollection 2022 Jun.
Most of the local anesthetic toxicity cases develop within the first five minutes of peripheral block administration. Late local anesthetic toxicity has been rarely reported in the literature. However, it is an important life-threatening problem that can lead to seizures, hemodynamic collapse, and cardiac arrest if it is ignored and not considered. Here we present the case of an 18-year-old male patient who had ultrasonography-guided infraclavicular brachial plexus block administration with a 30 mL local anesthetic. The patient had convulsions 210 minutes after the block administration and was treated with intravenous diazepam. Intraoperative and postoperative courses were uneventful. He had no neurologic signs or symptoms afterward. All laboratory tests and radiologic investigation tests were normal. This report demonstrates that late local anesthetic toxicity is still possible after several hours of the uneventful peripheral neural blockade, although it is rarely reported.
大多数局部麻醉药中毒病例发生在外周阻滞给药的前五分钟内。文献中很少报道迟发性局部麻醉药中毒。然而，这是一个重要的危及生命的问题，如果被忽视且未得到重视，可能导致癫痫发作、血流动力学崩溃和心脏骤停。在此，我们报告一例18岁男性患者，他接受了超声引导下锁骨下臂丛神经阻滞，注射了30毫升局部麻醉药。患者在阻滞给药210分钟后出现惊厥，接受了静脉注射地西泮治疗。术中及术后过程顺利。此后他没有神经体征或症状。所有实验室检查和影像学检查均正常。本报告表明，尽管迟发性局部麻醉药中毒很少被报道，但在外周神经阻滞平稳进行数小时后仍有可能发生。
