Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, Deutschland. christian.zimmer@uk-essen.de
Accidental intravascular administration of bupivacaine can cause severe neurotoxic and cardiotoxic effects. We report a case of suspected bupivacaine intoxication due to intravascular injection via an epidural catheter and treatment with lidocaine, propofol, and a 20% lipid emulsion resulting in fast resolution of cardiotoxic and neurotoxic effects. Possible mechanisms of action of the medications used are discussed.