Successful resuscitation from cardiac arrest associated with extradural lidocaine in a dog. 2006

Ioannis Savvas, and Tilemahos Anagnostou, and Lysimachos G Papazoglou, and Dimitris Raptopoulos
Clinic of Surgery, Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, St. Voutyra 11, GR-546 27 Thessaloniki, Greece. isavas@vet.auth.gr

BACKGROUND Extradural lidocaine exerts several adverse effects which are seldom fatal. While cardiac arrest following extradural lidocaine injection has been reported in human beings, it has not hitherto been reported in dogs. METHODS The emergency management of a dog with complete urethral obstruction is described. We intended to perform vaginoscopy and cystostomy under extradural lidocaine anaesthesia, but cardiac asystole occurred a few minutes after injection. Resuscitation was successful. About 20 minutes later cardiac arrest recurred, and was treated successfully. The dog remained hypothermic for approximately 7 hours. Complete recovery without neurological deficit occurred the next day and the dog remained normal for at least 3 months. The probable cause of the problem was cranial lidocaine dispersion causing a drop in cardiac preload and cardiac arrest. The successful neurological outcome was attributed to early diagnosis and effective treatment. Hypothermia may have conferred cerebral protection during ischemia. CONCLUSIONS Extradural local anaesthetic administration is not without risk and the technique should be tailored to individual animals. Constant monitoring is required to detect potentially fatal complications and increase the likelihood of successful outcome.

UI MeSH Term Description Entries
D007268 Injections, Epidural The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater. Epidural Injections,Extradural Injections,Peridural Injections,Injections, Extradural,Injections, Peridural,Epidural Injection,Extradural Injection,Injection, Epidural,Injection, Extradural,Injection, Peridural,Peridural Injection
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D004283 Dog Diseases Diseases of the domestic dog (Canis familiaris). This term does not include diseases of wild dogs, WOLVES; FOXES; and other Canidae for which the heading CARNIVORA is used. Canine Diseases,Canine Disease,Disease, Canine,Disease, Dog,Diseases, Canine,Diseases, Dog,Dog Disease
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005260 Female Females
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D016887 Cardiopulmonary Resuscitation The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE. Basic Cardiac Life Support,CPR,Code Blue,Mouth-to-Mouth Resuscitation,Cardio-Pulmonary Resuscitation,Life Support, Basic Cardiac,Cardio Pulmonary Resuscitation,Mouth to Mouth Resuscitation,Mouth-to-Mouth Resuscitations,Resuscitation, Cardio-Pulmonary,Resuscitation, Cardiopulmonary,Resuscitation, Mouth-to-Mouth,Resuscitations, Mouth-to-Mouth

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