A 38-year-old woman undergoes peripheral nerve block before surgery. Minutes after injection, she develops circumoral numbness, tinnitus, and generalized seizures followed by ventricular arrhythmias. Vital signs show BP 88/52 mmHg, HR 142/min, RR 28/min. Serum glucose is normal. She denies prior seizure history. ECG demonstrates prolonged QRS duration. Accidental intravascular injection of which of the following local anesthetic most likely caused this toxidrome?
- A)Heparin
- B)Ipratropium
- C)Furosemide
- D)Lidocaine or bupivacaineGABARITO
- E)Nitroprusside
Explicação
Local anesthetic systemic toxicity presents with early neurologic symptoms such as circumoral numbness and tinnitus followed by seizures and cardiovascular collapse. Lidocaine and especially bupivacaine are classic agents. Recognition of the toxidrome is high ... Ver explicação completa e trilha adaptativa →