Abstract

PALAZON CABANES, Begoña et al. Lipid emulsion as an antidote to progressive neurological impairment after injection of high doses of local anesthetic: case report. Acta Neurol Colomb. [online]. 2016, vol.32, n.2, pp.140-143. ISSN 0120-8748.

The infiltration of local anesthetic (LA) is increasingly widespread as an indication in the treatment of neuropathic pain. AL poisoning is rare but serious, life-threatening entity and its management may be very difficult. It occurs with decreased level of consciousness, seizures and cardiac conduction blocks. The lipid emulsion (EL) 20% is the only specific treatment described to date and it has improved the prognosis of these patients. We report the case of a patient with progressive neurological deterioration after injection of high doses of LA for treat a neuropathic pain refractory to other treatments. The patient was treated with lipid emulsion 20% with reversing all the neurological symptoms early and completely. The occurrence of progressive neurological symptoms in the context of a local anesthetic infiltration, should alert us to a possible poisoning and to start early treatment with lipid emulsion 20%, to avoid poor prognosis. However, prevention remains the main tool.

Keywords : Lipids; emulsion; toxic effects; local anesthetic; neuropathic pain.

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