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Kardio- und neurotoxische Nebenwirkungen nach akzidenteller intravasaler Bupivacainapplikation

Therapie mit Lidocain, Propofol und Lipidemulsion

Cardiotoxic and neurotoxic effects after accidental intravascular bupivacaine administration

Therapy with lidocaine propofol and lipid emulsion

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Zusammenfassung

Eine akzidentelle intravasale Bupivacainapplikation kann schwere neuro- und kardiotoxische Nebenwirkungen verursachen. Es wird über einen Fall einer vermuteten Bupivacainintoxikation nach intravasaler Applikation über einen Periduralkatheter berichtet, deren Behandlung mithilfe Lidocain, Propofol und 20%iger Lipidemulsion zu schnellem Sistieren der kardio- und neurotoxischen Effekte führte. Mögliche Wirkmechanismen der verwendeten Medikamente werden diskutiert.

Abstract

Accidental intravascular administration of bupivacaine can cause severe neurotoxic and cardiotoxic effects. We report a case of suspected bupivacaine intoxication due to intravascular injection via an epidural catheter and treatment with lidocain, propofol, and a 20% lipid emulsion resulting in fast resolution of cardiotoxic and neurotoxic effects. Possible mechanisms of action of the medications used are discussed.

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  1. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    C. Zimmer, K. Piepenbrink, G. Riest & J. Peters

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  1. C. Zimmer
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  2. K. Piepenbrink
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  3. G. Riest
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  4. J. Peters
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Correspondence to C. Zimmer.

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Zimmer, C., Piepenbrink, K., Riest, G. et al. Kardio- und neurotoxische Nebenwirkungen nach akzidenteller intravasaler Bupivacainapplikation. Anaesthesist 56, 449–453 (2007). https://doi.org/10.1007/s00101-007-1147-3

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  • DOI: https://doi.org/10.1007/s00101-007-1147-3

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