[ @entity1342 -induced late-onset XXXX after transversus abdominis plane block under general anesthesia: successful reversal with 20% lipid emulsion].

@entity1 @entity410 @entity137 @entity3175 @entity1342 @entity551
We report a case of late-onset @entity137 due to @entity1342 over dose, and its successful reversal with 20% lipid emulsion (20% Intralipos). A 40-year-old @entity1 , 40 kg, ASA-I, was scheduled for laparoscopy-assisted myomectomy of the uterus in which 40 ml of 0.375% @entity1342 was injected for bilateral US guided transversus abdominis plane block (TAPblock) under general anesthesia. Anesthesia proceeded uneventfully and she could go back to the ward 15 min later, but 3 hours after TAPblock, her blood pressure dropped to seventies and she became unresponsive. She also displayed @entity410 /twitching of limbs. Immediately after @entity3175 2 mg injection, @entity410 disappeared and she could obey verbal commands. Within a few minutes @entity410 was noted again, and she was @entity551 despite administration of vasopressors. A presumptive diagnosis of @entity137 was made, and she received 100 ml bolus of 20% Intralipos. She regained consciousness with spontaneous return of blood pressure. She received a total of 230 ml 20% Intralipos, which was discontinued due to her rapid emergence with no further @entity410 episodes. This case suggests that early and sufficient use of lipid emulsion may lead to a good outcome. We recommend the immediate availability of lipid emulsion along with other emergency therapeutics at the ward after TAPblock.
