Probable Local Anesthetic Systemic Toxicity in a Postpartum Patient with Acute Fatty Liver of Pregnancy After a Transversus Abdominis Plane Block

We present the case of a 25-year-old woman with acute fatty liver of pregnancy, a rare mitochondrial disorder that manifests during pregnancy and has a significant mortality rate. Postoperative pain management is challenging for myriad reasons. With the increasing application of transversus abdominis plane blocks for postcesarean delivery analgesia, we describe the real and potential complications of this method of regional analgesia in patients with this disease.