During elective elbow surgery, a patient stops from breathing and develops tonic-clonic seizure after receiving anesthesia. What happened to him? How will you handle this case? A 42-year-old man (ASA 1) is scheduled for an elective elbow surgery. His weight is 72 kg and he is 6 ft tall. He consents to an interscalene block as he would prefer not to have a general anesthetic. In the preoperative holding area, an IV is placed.
Sedation, consisting of 2 mg midazolam and 50 mcg of fentanyl is given. The block is done in the following manner. The interscalene grove is identified at the level of C6 using a Stimuplex-DIG nerve stimulator. The brachial plexus is identified by eliciting a biceps stimulation (0.1 ms duration, 2 Hz) 0.4 mA. A 40 mL solution consisting of (20 mL bupivacaine, 0.5% and 20 mL mepivacaine 1.5%) is injected slowly over a 2 min period. The patient is awake during the…
