LipidRescue™ Resuscitation

78 y/o female for right TKA , PM hx obesity, DM, HTN. Underwent mepivacaine spinal and had propofol running at 100 mcg/kg/min with LMA in place. After tibial cuts, her HR went to 148 and BP went to 240/140. At that time the surgeon informed me that 30 ml plain bupivacaine had been inadvertently injected into the tibial IM canal. She proceeded to develop hypotension, bradycardia with PVCs, and desaturation. A Code was called, intralipid started, she was intubated, and went into PEA, CPR was started and 1 mg epi was given with ROSC. She was stable and an a-line and CVL were placed. The surgery was completed and she was taken to ICU ventilated. She was extubated 4 hours later, discharged to thr ortho floor the next day and home the next day with no deficites.