Post Your Cases > Increases anxiety, tachycardia, carpal spasm after adductor canal block
17 y/o, healthy, 76 kg, male for knee scope/meniscus repair, surgeon requested a block. The patient was extremely needle phobic, started hyperventilating and needed a emesis bag before the ACB. 25 ml of 3.75% bup with 1:400,000 epi. Easy block, neg aspirations, viewed needle tip and vessels easily. About 6-10 minutes later: HR>140, hyperventilating even more, carpal spasms worse on right hand, complained of numb face and metallic taste. I gave 20 mcg precedex while waiting for intralipid. After about 200 ml he was totally better. Sent him to the ER to monitor ECG/vital signs for 6 hours. His toxic dose would be over 190 mg, he got about 94 mg.
His toxic dose would be over 190 mg, he got about 94 mg.