• Ann-Marie Crowe and Branislav Mislovič.
• Department of Anaesthesiology, Critical Care and Pain Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland.
• Paediatr Anaesth. 2022 Mar 1; 32 (3): 479-481.

AbstractA 6-day-old, 4.0 kg neonate presented with intestinal malrotation, necessitating laparotomy. Intra-operatively, an ultrasound-guided erector spinae plane block was performed under general anesthesia with administration of 1 mg/kg levobupivacaine. Minutes following this, acute cardiac compromise was evident from a tapering end-tidal carbon dioxide, falling oxygen saturations, and low blood pressure. Intravenous epinephrine 1 mcg/kg was administered, with some hemodynamic improvement. Intralipid (1.5 ml/kg) was given, with a return to normal hemodynamic parameters. This is the first case report of suspected local anesthetic toxicity in a neonate following an erector spinae plane block.© 2021 John Wiley & Sons Ltd.

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