• Acta Med Okayama · Dec 2019

    Case Reports

    Local Anesthetic Systemic Toxicity Following General and Epidural Anesthesia in A patient with a History of Muscle Relaxant-induced Anaphylaxis.

    • Asuka Kubo, Kazuyoshi Shimizu, Kosuke Kuroda, Tomoyuki Kanazawa, Motomu Kobayashi, and Hiroshi Morimatsu.
    • Department of anesthesiology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Yamaguchi 740-8510, Japan.
    • Acta Med Okayama. 2019 Dec 1; 73 (6): 543-546.

    AbstractWe here report that a 71-year-old Japanese woman with a history of anaphylaxis induced by muscle relaxants had local anesthetic systemic toxicity (LAST) following an abdominal surgery under general anesthesia with combined spinal-epidural anesthesia without muscle relaxants. The total dosages of local anesthetics reached 0.67 mg/kg of ropivacaine and 11.5 mg/kg of lidocaine over 12.5 h to obtain sufficient muscle relaxation for surgery. Regional anesthesia is useful in cases in which muscle relaxants are to be avoided during a surgery. However, especially for a patient with risk factors and prolonged surgery, precautions should be taken to prevent LAST.

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