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주관절 전치환 수술을 위한 상완신경총 차단술을 시행하는 도중 발생한 국소마취제의 전신 독성 1례 - 증례보고 -

Local Anesthetics Toxicity during Brachial Plexus Block for Total Elbow Replacement Surgery - A Case Report -

경희의학 2019년 34권 1호 p.59 ~ 59
이현정, 황태준, 강희용,
소속 상세정보
이현정 ( Lee Hyun-Jeong ) - 경희대학교 의과대학 마취통증의학교실
황태준 ( Hwang Tae-Jun ) - 경희대학교 의과대학 마취통증의학교실
강희용 ( Kang Hee-Yong ) - 경희대학교 의과대학 마취통증의학교실

Abstract


Brachial plexus block is widely used technique for upper limb surgery. However, systemic toxicity can occur if local anesthetics are injected into the blood vessels or systemically absorbed. We experienced seizures after brachial plexus block. A 72-year-old female patient underwent ultrasound-guided supraclavicular brachial plexus block for left-sided revision total elbow replacement. At 15 minutes after injecting 30 mL of mepivacaine, the patient showed confusion and convulsion in her arms and legs. To minimize systemic toxicity, propofol 30 mg and midazolam 2 mg were administered, mask ventilation was performed, and lipid emulsion was infused at a rate of 0.25 ml/kg/min for 15 minutes intravenously. The operation was postponed and the patient recovered without sequalae after being transferred to intensive care unit. We report our clinical experience with a review of the relevant literature.

키워드

Brachial plexus block; Lipid emulsion; Local anesthetics; Seizures; Toxicity

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