Successful resuscitation of bupivacaine systemic intoxication after intercostal block in pediatrics undergoing patent ductus arteriosus ligation (PDA) surgery

Abstract

This article reports a 3-month-old baby girl with Patent Ductus Arteriosus (PDA) with PDA ligation surgery, performed postoperative intercostal peripheral nerve block. Cardiac toxicity occured with features of ventricular extrasystole bigeminy and AV block with signs of cardiac depression immediately after peripheral intercostal nerve block. Administration of intravenous 20% lipid emulsion, epinephrine, and antiarrhythmics improved hemodynamic conditions after 2 hours postoperatively.