![]() During the first 20 min of advanced cardiac life support, a total of 3 mg epinephrine, given in divided doses, 2 mg atropine, 300 mg amiodarone, and 40 U arginine vasopressin were administered. Tube position was confirmed by auscultation, after which chest compressions were immediately resumed. The trachea was intubated, and end-tidal carbon dioxide was detected with an Eas圜ap®II (Nellcor Inc., Hayward, CA). Advanced cardiac life support was immediately started. The electrocardiogram showed asystole, and no pulse, by carotid or femoral palpation, or blood pressure was detectable. Approximately 90 s later, the patient began to seize again this time, 100 mg intravenous propofol was administered. The seizure stopped, and spontaneous respirations resumed. Oxygen was delivered by a facemask attached to a self-inflating resuscitation bag while 50 mg propofol was injected intravenously. At no time was any blood aspirated, nor did he report pain or paresthesias.Īpproximately 30 s after removal of the block needle, the patient became incoherent and then developed a tonic–clonic seizure. ![]() The patient was awake and conversant during the performance of the block. The brachial plexus was identified by eliciting biceps stimulation (0.1-ms duration, 2 Hz) at 0.34 mA, following which 40 ml local anesthetic solution (20 ml bupivacaine, 0.5%, and 20 ml mepivacaine, 1.5%) were injected slowly (over approximately 2.5 min) in 5-ml increments with gentle aspiration between doses. Braun, Inc., Bethlehem, PA), and the interscalene groove was identified at the level of C6. A 50-mm, 22-gauge Stimuplex® insulated needle was connected to a Stimuplex®-DIG nerve stimulator (both B. A 20-gauge intravenous catheter was placed in the dorsum of his left hand, through which 2 mg midazolam and 50 μg fentanyl were administered. Supplemental oxygen was delivered at 3 l/min via a nasal cannula. Blood pressure was 120/80 mmHg, room air oxygen saturation measured by pulse oximetry was 98%, and heart rate was 60 beats/min. The patient arrived at the operating room holding area, where standard monitors were applied.
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