Case Study: Local Anesthetic Toxicity After Bier Block. Was intralipid Therapy the Correct Remedy

Introduction: Intralipid therapy is recommended for patients with local anesthetics like Bupivacaine, but it is not advisable for patients with short acting local anesthetic toxicity like Lidocaine. Presentation of case: 42 years old healthy female was brought to Operating room for release of carpel tunnel syndrome of left hand. It was decided to perform Bier block. After placement of successful Bier block, surgery was completed in twenty minutes and after tourniquet release, pt. noted to have shaking movement. Local anesthetic toxicity was suspected as the tourniquet was released too soon, before the recommended time of forty fi ve minutes. ACLS protocol was initiated providing oxygen to patient and providing assistance on breathing and taking care of airway. Patient initially was confused and agitated. But recovered after few minutes and very soon became awake and alert. She was kept on observation for few hours before being discharged. The question was, could intralipid therapy would have been helpful in patients with lidocaine toxicity.