Lidocaine
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Cardiac arrest: case report A 64-year-old woman developed cardiac arrest following application of lidocaine as local anaesthesia. The woman received topical administration of lidocaine cream (2.5%) as local anaesthesia, before the micro-needling procedure. An hour following application, she developed cardiac arrest. Subsequently, she underwent manual cardiopulmonary resuscitation (CPR) and was transferred to hospital in the Iran. She again developed cardiac arrest and CPR was performed again for 30 minutes, followed by intubation. Echocardiography showed left-ventricular (LV) dysfunction after CPR. The next day, she was extubated; however, she developed a fever, leucocytosis, paraesthesia and distal sensory-motor weakness. After neurological consultation, she underwent brain MRI and a brain CT-scan, which demonstrated a small old haemorrhage in the sub-occipital region on both sides. She received treatment with meropenem and vancomycin for 5 days for fever. ECG was performed again, which revealed mild tricuspid regurgitation and LV diastolic dysfunction. However, fever was recorded again 10 days after the completion of antibiotic course. Therefore, chest-CT scan was performed after infectious consultation, which showed bilateral parenchymal lower lobe aspiration pneumonia; therefore, she was again prescribed on antibiotics including amoxicillin /clavulanic acid, vancomycin and azithromycin. She reported mild chest pain before intubation. Therefore, noninvasive CT angiography was performed for coronary evaluation, in which intramural haematoma of the thoracic descending aorta was observed. The woman underwent thoracic Endovascular Aortic Repair (TEVAR) through the bilateral accessory femoral artery to treat intramural haematoma. She was followed with CT-scan after 4 days that reported well seated and patent aortic stent-graft without residual flow. She was discharged 1 month after hospitalisation. She was in a good general condition at the time of discharge. She was prescribed atorvastatin, furosemide and carvedilol. She referred to the heart clinic after 2 weeks, at that time her condition was normal without any complaints. The progression of the size of haematoma demonstrated that lesion happened due to CPR. Safi M, et al. Cardiac arrest after topical application of lidocaine during microneedling procedure: A rare case. Dermatologic Therapy : no pagination, 13 Oct 2020. Available 803515409 from: URL: http://doi.org/10.1111/dth.14406
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Reactions 14 Nov 2020 No. 1830
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