Martyn Harvey, FACEM, Emergency Physician, Director Emergency Medicine Research, Clinical Senior Lecturer (Hon); Grant Cave, FACEM, FJFICM, Emergency Physician, Intensivist, Clinical Senior Lecturer (Hon); Giles Chanwai, FACEM, Emergency Physician; Tonia Nicholson, FACEM, Emergency Physician.
Successful resuscitation from bupivacaine-induced cardiovascular collapse with intravenous lipid emulsion following femoral nerve block in an emergency department
Article first published online: 14 APR 2011
© 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia
Volume 23, Issue 2, pages 209–214, April 2011
How to Cite
Harvey, M., Cave, G., Chanwai, G. and Nicholson, T. (2011), Successful resuscitation from bupivacaine-induced cardiovascular collapse with intravenous lipid emulsion following femoral nerve block in an emergency department. Emergency Medicine Australasia, 23: 209–214. doi: 10.1111/j.1742-6723.2011.01401.x
- Issue published online: 14 APR 2011
- Article first published online: 14 APR 2011
- Accepted 11 February 2011
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.