LipidRescue™ Resuscitation

Today we had a 35 yr old 70 kg male with fracture proximal humerus for surgery. We gave USG plus nerve stimulator guided interscalene nerve block with 20ml 0.5%bupivacaine and 10ml 2%lignocaine. The sensory and motor block was good. About 45 min later when the surgeons were scrubbing the affected limb to prepare for surgery, the patient had a cardiac arrest. Immediate CPR with 250ml 30% intralipid (this prep was available at that moment) reverted the patient to sinus rhythm in 5min. Serum bupivaicaine levels could not be checked. We are not sure whether it was drug toxicity or fat embolism.