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Thanks to Reviewers 2014 Keywords AcEMC Antidotes Decision making Emergency Care Unit Emergency Department Emergency Unit Emergency medicine Interdisciplinary National Congress Pronto Soccorso Rome Triage Uneasiness acute idiopathic megacolon emergency emergency care unit emergency department literature triage ultrasonographic diagnosis web 2011 Article Tools Print this article Indexing metadata How to cite item Email this article (Login required) Email the author (Login required) Home > Vol 10, No 1 (2014) > Monti Cover Image
DOI: http://dx.doi.org/10.4081/ecj.2014.1820 Treatment with lipid therapy to resuscitate a patient suffering from toxicity due to local anesthetics Authors Manuel Monti, Alessio Monti, Francesco Borgognoni, Giovanni Maria Vincentelli, Federico Paoletti
Authors information
Manuel Monti Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy. montimanuel@tiscali.it
Alessio Monti Department of Engineering, Roma Tre University, Rome, Italy.
Francesco Borgognoni Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy.
Giovanni Maria Vincentelli Emergency Department, Fatebenefratelli Hospital, Rome, Italy.
Federico Paoletti Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy.
Abstract
Recently, although without a universal recognition, the use of lipid emulsions as a rescue therapy for the bupivacaine cardiac toxicity has been proposed. In this article we report a successful resuscitation of a patient after the injection of bupivacaine in emergency room and a commented review of the related literature. The patient is a 73 years old man that, after a subcutaneous injection of bupivacaine (0.5%, i.e. 0.5 mL/h), developed circulatory arrest. After the failure of the initial treatment based on the advanced life support protocol, we have successfully performed a therapy with lipid emulsion. The bupivacaine intravascular injection, together with its interaction with amitriptyline and carbamazepine, could lead to cardiac depression, severe arrhythmias, hypotension, and/or cardiac arrest. In the case of failure of traditional life support treatment, intravenous lipid emulsion proves to be the best therapy to treat bupivacaine systemic toxicity.
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Thanks to Reviewers 2014
Keywords AcEMC Antidotes Decision making Emergency Care Unit Emergency Department Emergency Unit Emergency medicine Interdisciplinary National Congress Pronto Soccorso Rome Triage Uneasiness acute idiopathic megacolon emergency emergency care unit emergency department literature triage ultrasonographic diagnosis web 2011
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Print this article
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Home > Vol 10, No 1 (2014) > Monti
Cover Image
DOI: http://dx.doi.org/10.4081/ecj.2014.1820
Treatment with lipid therapy to resuscitate a patient suffering from toxicity due to local anesthetics
Authors
Manuel Monti, Alessio Monti, Francesco Borgognoni, Giovanni Maria Vincentelli, Federico Paoletti
Authors information
Manuel Monti
Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy. montimanuel@tiscali.it
Alessio Monti
Department of Engineering, Roma Tre University, Rome, Italy.
Francesco Borgognoni
Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy.
Giovanni Maria Vincentelli
Emergency Department, Fatebenefratelli Hospital, Rome, Italy.
Federico Paoletti
Emergency Department, Local Health Unit UMBRIA1, Assisi, Italy.
Abstract
Recently, although without a universal recognition, the use of lipid emulsions as a rescue therapy for the bupivacaine cardiac toxicity has been proposed. In this article we report a successful resuscitation of a patient after the injection of bupivacaine in emergency room and a commented review of the related literature. The patient is a 73 years old man that, after a subcutaneous injection of bupivacaine (0.5%, i.e. 0.5 mL/h), developed circulatory arrest. After the failure of the initial treatment based on the advanced life support protocol, we have successfully performed a therapy with lipid emulsion. The bupivacaine intravascular injection, together with its interaction with amitriptyline and carbamazepine, could lead to cardiac depression, severe arrhythmias, hypotension, and/or cardiac arrest. In the case of failure of traditional life support treatment, intravenous lipid emulsion proves to be the best therapy to treat bupivacaine systemic toxicity.