{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T09:54:43Z","timestamp":1789293283318,"version":"build-2803163510"},"reference-count":15,"publisher":"The Korean Society of Anesthesiologists","issue":"2","license":[{"start":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T00:00:00Z","timestamp":1640649600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"published-print":{"date-parts":[[2022,4,30]]},"abstract":"<jats:p>Background: Local anesthetics systemic toxicity (LAST) is a grave complication of regional anesthesia that usually occurs immediately after local anesthetics injection. Here, we report on rare late-onset toxicity cases after supraclavicular brachial plexus blocks.Case: Two patients underwent surgery for radius fractures. We used lidocaine 100 mg and ropivacaine 150 mg for blocking and infused dexmedetomidine for intraoperative sedation. The 63-year-old male patient\u2019s blood pressure dropped to 87\/60 mmHg after 3 h 15 min after blocking. Ventricular fibrillation occurred 10 min later. After five defibrillations, electrocardiography showed ventricular tachycardia that was normalized through one cardioversion. The 54-year-old female patient\u2019s heart rate decreased to 35 beats\/min 2 h 30 min after blocking. Her vital signs returned to normal after administering atropine, ephedrine, epinephrine, and lipid emulsion.Conclusions: Physicians should remember that LAST may occur long after local anesthetic injection and be aware of factors that may adversely affect the course of LAST.<\/jats:p>","DOI":"10.17085\/apm.21093","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T02:56:37Z","timestamp":1640660197000},"page":"228-234","update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Two cases of late-onset cardiovascular toxicities after a single injection of local anesthetics during supraclavicular brachial plexus block - A report of two cases -"],"prefix":"10.17085","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-5638","authenticated-orcid":true,"given":"Ji Yeon","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8208-4970","authenticated-orcid":true,"given":"Beom Il","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-8445","authenticated-orcid":true,"given":"Min Hee","family":"Heo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-9385","authenticated-orcid":true,"given":"Kyoung Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0315-1659","authenticated-orcid":true,"given":"Sang-Il","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-8109","authenticated-orcid":true,"given":"Kyung-Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-9451","authenticated-orcid":true,"given":"Won Joo","family":"Choe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-8120","authenticated-orcid":true,"given":"Jang Su","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9466-8399","authenticated-orcid":true,"given":"Jun Hyun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.2147\/lra.s154512"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15282"},{"key":"ref3","first-page":"783","volume-title":"Local anesthetic systemic toxicity: a narrative literature review and clinical update on prevention, diagnosis, and management","author":"Gitman","year":"2019"},{"key":"ref4","first-page":"124","volume-title":"Local anesthetic systemic toxicity: a review of recent case reports and registries","author":"Gitman","year":"2018"},{"key":"ref5","first-page":"372","volume-title":"Late onset of systemic toxicity of local anesthetics in brachial plexus block: a case report","author":"Oh","year":"2012"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.5152\/tjar.2015.50023"},{"key":"ref7","first-page":"470","volume-title":"Safe use of local anaesthetics: prevention and management of systemic toxicity","author":"Lui","year":"2010"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/78.5.507"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198911000-00003"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.06.009"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e31819237f8"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.aat.2011.11.010"},{"key":"ref13","first-page":"541","volume-title":"POFA Study Group; SFAR Research Network. Balanced opioid-free anesthesia with dexmedetomidine versus balanced anesthesia with remifentanil for major or intermediate noncardiac surgery: the postoperative and opioid-free anesthesia (POFA) randomized clinical trial","author":"Beloeil","year":"2021"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3944\/aott.2012.2706"},{"key":"ref15","first-page":"113","volume-title":"The third American Society of Regional Anesthesia and Pain Medicine practice advisory on local anesthetic systemic toxicity: executive summary 2017","author":"Neal","year":"2018"}],"container-title":["Anesthesia and Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/anesth-pain-med.org\/upload\/pdf\/apm-21093.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/anesth-pain-med.org\/journal\/view.php?doi=10.17085\/apm.21093","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/anesth-pain-med.org\/upload\/pdf\/apm-21093.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T05:04:26Z","timestamp":1651208666000},"score":1,"resource":{"primary":{"URL":"http:\/\/anesth-pain-med.org\/journal\/view.php?doi=10.17085\/apm.21093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,30]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.17085\/apm.21093","relation":{},"ISSN":["1975-5171","2383-7977"],"issn-type":[{"value":"1975-5171","type":"print"},{"value":"2383-7977","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,30]]},"assertion":[{"value":"2021-08-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-28","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}