LipidRescue™ Resuscitation

Lumbar plexus block performed with 21g stimulating need with adductor response down to 0.5mA. Negative aspiration every 5cc, dosing every 30 seconds for total of 25 cc of 0.25% Bupivicaine with 1:200K epi. One minute later, baseline HR of 50 changed to wide complex tachycardia to 116. Sixty cc's of 20% intralipid given within 1 minute with immediate return to SB, narrow complex. Carotid pulse was thready for about 20 seconds, but no CPR or PPV needed. Patient had been sedated with midazolam and fentanyl for nerve block procedure. No evidence of seizure activity. Surgery proceeded as planned after completion of total dose of 250 cc of Intralipid and monitoring of telemetry for 30 minutes.