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I had a patient schechuled for a knee fracture. I was performing a sciatic nerve block with bupivacaina 0.5% 10ml and lidocaina 1% 10ml. After 15 ml with negative aspiration every 3ml the patient start to complain of numbness, metal taste in his mouth and agitation. No cardiovascular abnormaility was seen at the monitor. The pulseoxymeter decrease to 80%. During that situation we call for help, mantenin the pulseoxymeter above 95% with hand bag support. After 30 seconds the patient start to fell better so we decided to not use Lipid infusion. The surgery was done witouth a problem and the patiente did well.
The big question is: should we have used lipid infusion earlier during that situation??, in wich moment do you decided to use it, because there is no cardinal sign that encourage to use it.
We presente this case in our department and the questions remain unanswer.
November 4, 2016 | Unregistered Commenterjuan pablo aristizabal