We report the case of a 25-year-old female scheduled for laparoscopic gynecologic surgery under general anesthesia. At the end of laparoscopy, an intraperitoneal infiltration (ropivacaine 0.75%, 20 mL) was administered by the surgeon without informing the anesthesiologist. After tracheal extubation due to significant postoperative pain, the anesthesiologist performed a bilateral transversus abdominis plane block (ropivacaine 0.75%, 40 mL). A seizure followed by ventricular arrhythmia developed 10 minutes after local anesthetic injection. An infusion of 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. This overdose could have been avoided with better communication between anesthesiologist and surgeon.
From the Departments of *Anesthetics and Intensive Care and †Obstetrics and Gynecology Surgery, Rouen University Hospital, Rouen, France.
Accepted for publication April 5, 2013.
Funding: Not funded.
The authors declare no conflicts of interest.
Address correspondence to Vincent Compere, MD, PhD, Department of Anesthetics and Intensive Care, Rouen University Hospital, 1 Rue de Germont, 76031 Rouen, France. Address e-mail to firstname.lastname@example.org.