• A&A practice · Apr 2024

    Case Reports

    Local Anesthetic Systemic Toxicity in Cardiac Surgery Patient with Erector Spinae Plane Catheter: A Case Report.

    • Derek Smith, TsuiBan C HBCH, and Cynthia Khoo.
    • From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA.
    • A A Pract. 2024 Apr 1; 18 (4): e01771e01771.

    AbstractRegional anesthesia nerve blocks are increasingly used for patients undergoing cardiac surgery as part of multimodal pain management. Though rare, local anesthetic systemic toxicity (LAST) is a severe complication that requires vigilant monitoring. We present a case of a postcardiac surgery patient who developed LAST multiple days after surgery from lidocaine via an erector spinae plane catheter. This episode was determined to be a result of impaired lidocaine metabolism from liver shock caused by worsening pulmonary hypertension. Even under continuous monitoring, patients with cardiac or liver dysfunction are at increased risk of complications from local anesthetics.Copyright © 2024 International Anesthesia Research Society.

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