A fit and healthy 34 years old man is having an inguinal hernia repair carried out under local anesthetic. He has continued to complain of some pain during the operation so he has been given another 20 mls of long-acting local anesthetic. He suddenly becomes very anxious, complains of numbness and tingling around his mouth and starts to shake and become unresponsive.
Rohan Khandelwal sir, What is the diagnosis of this case and What are the treatments for this patient in this situation?
Already explained above…
In chapter of epidural anaesthesia… i shared few of my clinic experiences …
LA systemic toxicity
immediately after giving LA c/o Perioral numbness + became unresponsive (could be due to cardio-respiratory arrest ) : likely diagnosis is Local anaesthetic systemic toxicity
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maintain airway
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Start CPR if patient is pulseless + give 20% intralipid iv at 1.5ml/kg bolus
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if throwing any seizure like ep like body shaking : iv midaz 2mg stat
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amiodarone if arrythmia develops on ECG lead
good amidoraine not first option… institute ACLS …