Inadvertent Intrathecal Administration of Local Anesthetics Leading to Spinal Paralysis with Lipid Emulsion Rescue

Abstract

Bupivacaine and ropivacaine are local anesthetics frequently used for interscalene nerve blocks, which are generally well tolerated; however, some complications include pneumothorax, Horner syndrome, nerve injury and cardiovascular toxicity from vascular injection. On rare occasions, it may be associated with spinal paralysis. While the treatment is mostly supportive, we report an unusual case of administering intravenous lipid emulsion (ILE) as part of resuscitative efforts to hasten neurological recovery from spinal shock.