Abstract
Background
Extradural lidocaine exerts several adverse effects which are seldom fatal. While
cardiac arrest following extradural lidocaine injection has been reported in human
beings, it has not hitherto been reported in dogs.
Observations
The emergency management of a dog with complete urethral obstruction is described.
We intended to perform vaginoscopy and cystostomy under extradural lidocaine anaesthesia,
but cardiac asystole occurred a few minutes after injection. Resuscitation was successful.
About 20 minutes later cardiac arrest recurred, and was treated successfully. The
dog remained hypothermic for approximately 7 hours. Complete recovery without neurological
deficit occurred the next day and the dog remained normal for at least 3 months. The
probable cause of the problem was cranial lidocaine dispersion causing a drop in cardiac
preload and cardiac arrest. The successful neurological outcome was attributed to
early diagnosis and effective treatment. Hypothermia may have conferred cerebral protection
during ischemia.
Conclusions
Extradural local anaesthetic administration is not without risk and the technique
should be tailored to individual animals. Constant monitoring is required to detect
potentially fatal complications and increase the likelihood of successful outcome.
Keywords
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Article info
Publication history
Accepted:
May 16,
2005
Received:
June 26,
2003
Identification
Copyright
© 2006 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
