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Case Report

A Case Report on Early-Onset Local Anesthetic Toxicity

Sushma Athota S., Nazia Nazir, Samiksha Khanuja, Ruchi Singh, Savita Gupta, Anupriya Saxena

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Indian Journal of Anesthesia and Analgesia 12(1):p 57-60, Jan- March 2025. | DOI: 10.21088/ijaa.2349.8471.12125.11

How Cite This Article:

Athota SS, Nazir N, et al. A case report on early-onset local anesthetic toxicity. Ind J Anesth Analg. 2025;12(1):57-60.

Timeline

Received : December 28, 2024         Accepted : January 29, 2025          Published : March 15, 2025

Abstract

Systemic toxicity of local anesthetics results from excessive plasma concentrations of these drugs, most often from accidental intravascular injection. Systemic reactions primarily involve the CNS and the cardiovascular system. In general, the CNS is more susceptible to the actions of systemic local anesthetics than the cardiovascular system is, and thus the dose or blood level of local anesthetic required to produce CNS toxicity is usually lower than that resulting in circulatory collapse[1]. Here we present the case of a 45-year-old male patient who had ultrasonography guided supra-clavicular brachial plexus block. The patient had an episode of seizure immediately (with-in 30 sec) after administering the local anesthetic (13 ml given in 5 ml aliquots injected after negative aspiration). He was treated with intravenous midazolam (2 mg stat) and supplemental oxygen via facemask. He had no neurological symptoms afterwards. All laboratory tests and radiological investigations were normal. This case report records the occurrence of local anesthetic toxicity observed as seizure activity, after ultrasound guided brachial plexus block due to accidental intravascular injection, as negative aspiration of the syringe does not always exclude intravascular placement.


References

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Data Sharing Statement

There are no additional data available.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

we hereby state that there were no ethical issues involved.

Acknowledgements

Consent for publication has been obtained from the patient.

Conflicts of Interest

The authors report no conflicts of interest in this work.


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Cite this article

Athota SS, Nazir N, et al. A case report on early-onset local anesthetic toxicity. Ind J Anesth Analg. 2025;12(1):57-60.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
December 28, 2024 January 29, 2025 March 15, 2025

DOI: 10.21088/ijaa.2349.8471.12125.11

Keywords

Case reportLocal anesthetic toxicitySupraclavicular brachial plexus blockSeizureIntravascular injection

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Received December 28, 2024
Accepted January 29, 2025
Published March 15, 2025

licence


Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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