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      Cardiac Arrest Following Liposuction: A Case Report of Lidocaine Toxicity

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          Abstract

          We report a case of a patient presenting to the emergency department in cardiac arrest following a liposuction procedure, which was performed in a physician office using lidocaine anesthesia. During liposuction of the thighs, using the power-assisted technique, the patient was given a subcutaneous dose of lidocaine equal to 71 mg/kg without any noticeable intraoperative complication. Two hours later, the patient experienced dizziness, a rapid decline in mental status, tonic-clonic seizure, and cardiac arrest. The patient was successfully resuscitated in the emergency department with the return of spontaneous circulation after 22 minutes of continuous advanced cardiovascular life support resuscitation. The patient suffered from subsequent severe hypoxic-ischemic brain injury, and a complicated hospital stay, including brain edema, electrolytes disturbances, and nosocomial infections contributed to her death two months later due to septic shock.

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          Most cited references13

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          ASRA practice advisory on local anesthetic systemic toxicity.

          The American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity assimilates and summarizes current knowledge regarding the prevention, diagnosis, and treatment of this potentially fatal complication. It offers evidence-based and/or expert opinion-based recommendations for all physicians and advanced practitioners who routinely administer local anesthetics in potentially toxic doses. The advisory does not address issues related to local anesthetic-related neurotoxicity, allergy, or methemoglobinemia. Recommendations are based primarily on animal and human experimental trials, case series, and case reports. When objective evidence is lacking or incomplete, recommendations are supplemented by expert opinion from the Practice Advisory Panel plus input from other experts, medical specialty groups, and open forum. Specific recommendations are offered for the prevention, diagnosis, and treatment of local anesthetic systemic toxicity.
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            Tumescent Technique for Regional Anesthesia Permits Lidocaine Doses of 35 mg/kg for Liposuction

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              Major and Lethal Complications of Liposuction: A Review of 72 Cases in Germany between 1998 and 2002

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                Author and article information

                Journal
                Oman Med J
                Oman Med J
                OMJ
                Oman Medical Journal
                OMJ
                1999-768X
                2070-5204
                July 2019
                : 34
                : 4
                : 341-344
                Affiliations
                [1 ]Emergency Department, American University of Beirut Medical Center, Beirut, Lebanon
                [2 ]Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
                [3 ]Georgia Poison Center, Atlanta, Georgia, USA
                Author notes
                [* ]Address correspondence and reprints request to: Sandra Mrad, Emergency Department, American University of Beirut Medical Center, Beirut, Lebanon. E-mail: dr.sandramrad@ 123456gmail.com
                Article
                OMJ-D-18-00023
                10.5001/omj.2019.66
                6642719
                be3ff4d2-5002-4704-857f-346dea1f6443
                The OMJ is Published Bimonthly and Copyrighted 2019 by the OMSB.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC) 4.0 License. http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 27 January 2018
                : 04 July 2018
                Categories
                Case Report
                Case Report

                liposuction,anesthesia,lidocaine,cardiac arrest,emergency department

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