Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report
Abstract Background Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are c...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-12-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-024-00763-8 |
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| author | Ryo Wakabayashi Seiichi Azuma Saori Hayashi Yuji Ueda Masaki Iwakiri Masaaki Asamoto Kanji Uchida |
| author_facet | Ryo Wakabayashi Seiichi Azuma Saori Hayashi Yuji Ueda Masaki Iwakiri Masaaki Asamoto Kanji Uchida |
| author_sort | Ryo Wakabayashi |
| collection | DOAJ |
| description | Abstract Background Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are critically needed. Case presentation A 48-year-old male patient (height: 182 cm, weight: 98 kg) underwent resection of a mediastinal goiter. He received 10 mL of 4% lidocaine for topical airway anesthesia and 20 mL of 1% lidocaine with 1:100,000 epinephrine for chest wall anesthesia. Thirty minutes after airway anesthesia, continuous theta waves appeared on the frontal electroencephalogram (EEG), which were enhanced following chest wall anesthesia. These waves transitioned into a repeating pattern and evolved into sharp periodic discharges. After administering 150 mL of 20% lipid emulsion, the EEG normalized. Conclusions This case highlights that EEG monitoring during general anesthesia may facilitate the early detection of LAST and provide real-time feedback on treatment efficacy. |
| format | Article |
| id | doaj-art-31ebdc262df04f18b6155c4ab456db9c |
| institution | Kabale University |
| issn | 2363-9024 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj-art-31ebdc262df04f18b6155c4ab456db9c2024-12-29T12:12:43ZengSpringerOpenJA Clinical Reports2363-90242024-12-011011410.1186/s40981-024-00763-8Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case reportRyo Wakabayashi0Seiichi Azuma1Saori Hayashi2Yuji Ueda3Masaki Iwakiri4Masaaki Asamoto5Kanji Uchida6Department of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo HospitalAbstract Background Local anesthetic systemic toxicity (LAST) is a rare but potentially life-threatening complication. Under general anesthesia, neurological signs are often masked, delaying diagnosis and increasing the risk of sudden cardiovascular collapse. Therefore, early detection methods are critically needed. Case presentation A 48-year-old male patient (height: 182 cm, weight: 98 kg) underwent resection of a mediastinal goiter. He received 10 mL of 4% lidocaine for topical airway anesthesia and 20 mL of 1% lidocaine with 1:100,000 epinephrine for chest wall anesthesia. Thirty minutes after airway anesthesia, continuous theta waves appeared on the frontal electroencephalogram (EEG), which were enhanced following chest wall anesthesia. These waves transitioned into a repeating pattern and evolved into sharp periodic discharges. After administering 150 mL of 20% lipid emulsion, the EEG normalized. Conclusions This case highlights that EEG monitoring during general anesthesia may facilitate the early detection of LAST and provide real-time feedback on treatment efficacy.https://doi.org/10.1186/s40981-024-00763-8ElectroencephalogramElectrographic seizuresEpileptiform dischargesLocal anesthetic systemic toxicity |
| spellingShingle | Ryo Wakabayashi Seiichi Azuma Saori Hayashi Yuji Ueda Masaki Iwakiri Masaaki Asamoto Kanji Uchida Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report JA Clinical Reports Electroencephalogram Electrographic seizures Epileptiform discharges Local anesthetic systemic toxicity |
| title | Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report |
| title_full | Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report |
| title_fullStr | Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report |
| title_full_unstemmed | Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report |
| title_short | Potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia: a case report |
| title_sort | potential role of electroencephalographic monitoring for diagnosis and treatment of local anesthetic systemic toxicity during general anesthesia a case report |
| topic | Electroencephalogram Electrographic seizures Epileptiform discharges Local anesthetic systemic toxicity |
| url | https://doi.org/10.1186/s40981-024-00763-8 |
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