Journal of Medical Academics

Register      Login

VOLUME 3 , ISSUE 2 ( July-December, 2020 ) > List of Articles

CASE REPORT

Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

Abdul Nasser, Faheem Raja

Keywords : Lipid emulsion therapy, Local anesthetic, Local anesthetic systemic toxicity, Peribulbar block

Citation Information : Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. Journal of Medical Academics 2020; 3 (2):67-68.

DOI: 10.5005/jp-journals-10070-0059

License: CC BY-NC 4.0

Published Online: 08-03-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae.


PDF Share
  1. Orbital regional anesthesia: complications and their prevention. Indian J Ophthalmol 2006;54(2):77-84. DOI: 10.4103/0301-4738.25826.
  2. Complication of peribulbar block: brainstem anaesthesia. Turk J Anaesthesiol Reanim 2017;45(4):231-233. DOI: 10.5152/TJAR.2017.95881.
  3. Brainstem anesthesia after retrobulbar block: a case report and review of literature. Ethiop J Health Sci 2016;26(6):589-594. DOI: 10.4314/ejhs.v26i6.13.
  4. Convulsions during cataract surgery under peribulbar anesthesia: a case report. J Med Case Reports 2014;8(1):218. DOI: 10.1186/1752-1947-8-218.
  5. Successful lipid rescue of local anesthetic systemic toxicity following peribulbar block. Med J Dr DY Patil Univers 2015;8(6):807-809. DOI: 10.4103/0975-2870.169942.
  6. Pulmonary edema after peribulbar block. Br J Anaesth 1999;82(5):777-779. DOI: 10.1093/bja/82.5.777.
  7. ASRA practice advisory on local anaesthetic systemic toxicity. Reg Anesth Pain Med 2010;35(2):152-161. DOI: 10.1097/AAP.0b013e3181d22fcd.
  8. Pre-treatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology 1998;88(4):1071-1075. DOI: 10.1097/00000542-199804000-00028.
  9. Lipid emulsion infusion: resuscitation for local anaesthetic and other drug overdose. Anesthesiology 2012;117(1):180-187. DOI: 10.1097/ALN.0b013e31825ad8de.
  10. Local anesthetic systemic toxicity: current perspectives. Local Region Anesthe 2018;11:35-44. DOI: 10.2147/LRA.S154512.
  11. Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology 2006;105(1):217-218. DOI: 10.1097/00000542-200607000-00033.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.