Document Detail

Lipid resuscitation in a carnitine deficient child following intravascular migration of an epidural catheter.
MedLine Citation:
PMID:  19849674     Owner:  NLM     Status:  MEDLINE    
A child with cerebral palsy and carnitine deficiency developed ventricular arrhythmias with loss of cardiac output during elective surgery under general anaesthesia with concomitant epidural analgesia. Sinus rhythm was restored on administration of adrenaline, but hypotension persisted despite resuscitation. Bolus administration of 0.8 ml*kg(-1) (20 ml) lipid emulsion resulted in rapid improvement in cardiac output. Blood samples taken before and after the lipid bolus did not demonstrate toxic concentrations of bupivacaine. This case suggests that carnitine deficiency may increase susceptibility to bupivacaine cardiotoxicity.
G K Wong; D T Joo; C McDonnell
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-10-22
Journal Detail:
Title:  Anaesthesia     Volume:  65     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-05-05     Revised Date:  2010-06-23    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  192-5     Citation Subset:  AIM; IM    
Department of Anesthaesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
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MeSH Terms
Analgesia, Epidural / adverse effects*,  instrumentation
Anesthetics, Local / adverse effects*
Bupivacaine / adverse effects*
Carnitine / deficiency*
Cerebral Palsy / complications
Fat Emulsions, Intravenous / therapeutic use*
Foreign-Body Migration / complications
Heart Arrest / chemically induced,  therapy
Intraoperative Complications / chemically induced,  therapy
Medication Errors / adverse effects
Reg. No./Substance:
0/Anesthetics, Local; 0/Fat Emulsions, Intravenous; 2180-92-9/Bupivacaine; 541-15-1/Carnitine
Comment In:
Anaesthesia. 2010 Jun;65(6):650; author reply 650-1   [PMID:  20565404 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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