Post Your Cases > Intralipid for convulsion after caudal in 22 month old
10kg child for repeat hip surgery anaesthetized with sevoflurane. Caudal performed with 10mls chirocaine 0.25% through 22g cannula - negative aspiration 4 or 5 times. About 2 minutes later self limiting tonic clonic convulsion. 20% Intralipid 15mls given within 2 minutes followed by 50mls over 20 minutes. No progression to arrhythmia. Surgery postponed but hip spica replaced after 30 minutes uneventful monitoring. Well child with no history of fits, Glucose normal and apyrexial. Full neurological recovery. No motor block but some sensory block I think - hard to tell without surgery when in plaster from chest to foot. If I had used a muscle relaxant fit would have gone undetected and child may have progressed to arrhythmia/arrest.