Bupivacaine is a long-acting local anesthetic agent that is very widely used for cutaneous infiltration, peripheral nerve blocks, epidural anesthesia, and spinal anesthesia. Well-described cardiotoxic effects of bupivacaine and other members of its class include dysrhythmias, hypotension, and depression of cardiac output. The minimum IV dose of bupivacaine previously associated with significant...

We describe a unique complication of laparoscopic liver biopsy. The increased intra-abdominal pressure associated with carbon dioxide pneumoperitoneum produced haemodynamic stability by tamponading a trochar-induced retroperitoneal haemorrhage. After deflation of the abdomen, release of the tamponade resulted in acute cardiovascular collapse. Other complications associated with laparoscopic sur...

Venous air embolism (VAE) during intestinal endoscopy is a rare complication. We report a case of cardiovascular collapse due to VAE confirmed by transesophageal echocardiography (TEE) during intraoperative intestinal endoscopy. TEE detected air bubbles in the left ventricle up to 1 hour after the event. When a patient deteriorates during endoscopic procedures, VAE and possible paradoxical air ...

DEMOGRAPHICS Case Title: Dante Jackson’s Anterior Cruciate Ligament (ACL) Repair (Cardiovascular collapse from a “high spinal”). Patient Name: Dante Jackson. Case Description and Diagnosis: A spinal anesthetic that results in cardiovascular collapse in a 24-year-old healthy male presenting for repair of the left ACL injury. Simulation Developers: Yetunde Olutunmbi, MD; William McIvor, MD; and J...