Cardiogenic shock associated with loco-regional anesthesia rescued with left ventricular assist device implantation

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Abstract

A healthy 53 year old man developed profound cardiogenic shock following instillation of bupivacaine-lidocaine-epinephrine solution as a locoregional anesthetic for elective outpatient shoulder surgery. Intubation, resuscitation, and transfer to the nearby hospital were done: echocardiography showed profound biventricular dysfunction; cardiac catheterization showed normal coronary arteries. Despite placement of an intra-aortic balloon pump and intravenous vasoactive drugs, the patient remained in shock. Stabilization was achieved with emergent institution of cardiopulmonary bypass and placement of a temporary left ventricular assist device (LVAD). Twenty-four hours later, cardiac function normalized and the LVAD was removed. The patient was discharged five days later and remained with normal heart function in three-year follow-up. © 2010 Samuels et al; licensee BioMed Central Ltd.

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Samuels, L. E., Casanova-Ghosh, E., & Droogan, C. (2010). Cardiogenic shock associated with loco-regional anesthesia rescued with left ventricular assist device implantation. Journal of Cardiothoracic Surgery, 5(1). https://doi.org/10.1186/1749-8090-5-126

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