Key result
20% IV lipid emulsion normalizes hemodynamics and QRS duration in bupivacaine-induced cardiovascular collapse.
Why the study?
Immediate cardiovascular collapse after bupivacaine femoral nerve block requires effective resuscitation strategies including lipid emulsion therapy.
Does 20% intravenous lipid emulsion improve haemodynamic parameters and ECG QRS duration in a patient with bupivacaine-induced cardiovascular collapse?
Case Report (n=1)
Does 20% intravenous lipid emulsion improve haemodynamic parameters and ECG QRS duration in a patient with bupivacaine-induced cardiovascular collapse?
Intravenous lipid emulsion can successfully reverse bupivacaine-induced cardiovascular collapse and normalize haemodynamics in the emergency department setting.
May support lipid emulsion rescue in bupivacaine collapse; hypothesis-generating and requires prospective validation.
We report a case of a 69-year-old woman with femoral neck fracture undergoing bupivacaine femoral nerve block for preoperative analgesia in an ED. Seizure and cardiovascular collapse developed immediately after instillation of local anaesthetic. Resuscitation including 20% lipid emulsion was successful in achieving normalization of haemodynamic parameters and ECG QRS duration. No adverse sequelae of lipid administration were observed. We recommend the immediate availability of lipid emulsion in emergency room settings where local anaesthetics are used.
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Harvey et al. (2011) conducted a case report in Bupivacaine-induced cardiovascular collapse (n=1). Intravenous lipid emulsion was evaluated on Normalization of haemodynamic parameters and ECG QRS duration. Resuscitation with 20% intravenous lipid emulsion successfully achieved normalization of haemodynamic parameters and ECG QRS duration in a patient with bupivacaine-induced cardiovascular collapse.
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