Cardiac arrest after thoracic paravertebral block with ropiv
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TPVB is effective for intra- and postoperative analgesia for thoracotomy and laparotomy in children as well as in adults. Although it has been considered to be safer than epidural anesthesia from the point of epidural hematoma and spinal cord injury, as well as being able to be performed with ultrasound guidance, rare complications such as vascular puncture may occur.

This article reports on cardiac arrest induced by 0.375 % ropivacaine 7 ml administered via a catheter for continuous thoracic paravertebral block (TPVB) in a 6-year-old female who underwent pacemaker implantation for sick sinus syndrome (SSS). She was successfully resuscitated with adrenaline and lipid emulsion. Plasma concentration of ropivacaine was 5.2 μg/ml, suggesting intravascular administration of ropivacaine. Inadvertent intravascular administration is a crucial complication of TPVB...

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