LipidRescue™ Resuscitation

71 year-old male, 64 kg ASA 3,admitted from ER with intractable left hip pain. Total left hip replacement planned for avascular necrosis. Patient underwent lumbar plexus block in pre-op area prior to surgery. Aspirate negative for blood prior to injection of local anesthetic. After 15cc of 0.5% Bupivicaine with epinephrine injected - slowly and in 5cc increments with negative aspirate after each 5 cc- pt reported feeling "dizzy" and then developed tonic-clonic seizure followed by ventricular fibrillation. Code called and CPR started. Pt received 1 amp of epinephrine, 5 mg versed, 2 amps of sodium bicarbonate and approximately 500 cc of lipids. Pt was also defibrillated x1 with 120 Joules. Pt had brief period of asystole followed by NSR during code. Pt was intubated, central and arterial lines were placed and pt was transferred to ICU on dopamine, levophed and lipid infusions. Pt in sinus tachycardia and hypotensive upon transfer to ICU. Pt. stabilized, was extubated in 24 hours, transferred to a telemetry unit in 2 days and discharged from the hospital after several days. Pt was alert and oriented within 12 hours after code. Surgery delayed until later date.