Abstract
Local anesthetics (LA) are extensively used and usually thought to be relatively safe. However lack of information about their toxic doses, side effects and treatment management of toxicity cause complications related to LA. A 19 years old male patient scheduled for shoulder arthroscopy with interscalene block. After the patient described pain, surgeon used 40 mL 2% prilocaine for LA infiltration. In post-anesthesia care unit, patient's peripheral oxygen saturation began to decrease, respiratory distress, aphasia and unconsciousness developed. These symptoms were evaluated as LA systemic toxicity and 20% intravenous lipid emulsion treatment had been started. After the bolus dose of intravenous lipid emulsion, neurological symptoms regressed. The metHb level was 28%. Intravenous methylene blue infusion was administered for methemoglobinemia. It was emphasized that it is necessary to increase awareness and knowledge about side effects, toxic doses of LA and their treatments.
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