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Indian Journal of Anesthesia and Analgesia 12(1):p 57-60, Jan- March 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12125.11
Case Report
A Case Report on Early-Onset Local Anesthetic Toxicity
Nazia Nazir, Sushma Athota S., Samiksha Khanuja, Ruchi Singh, Savita Gupta, Anupriya Saxena
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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.
Indian Journal of Anesthesia and Analgesia 12(1):p 57-60, Jan- March 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12125.11
How Cite This Article:
Sushma Athota S., Nazia Nazir, 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 25, 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.
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Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
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Cite this article
Sushma Athota S., Nazia Nazir, 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 25, 2025 |
DOI: https://doi.org/10.21088/ijaa.2349.8471.12125.11
Keywords
Case reportLocal anesthetic toxicitySupraclavicular brachial plexus blockSeizureIntravascular injectionSearch for Similar Articles
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Timeline
| Received | December 28, 2024 |
| Accepted | January 29, 2025 |
| Published | March 25, 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.
