Successful use of lipid emulsion to resuscitate a foal after intravenous lidocaine induced cardiovascular collapse.

The research paper presents a study where lipid emulsion was successfully used to revive a young horse (foal) that experienced a cardiovascular collapse due to an overdose of the local anaesthetic, lidocaine.

Research Objective

The paper is aimed at documenting a successful instance of treating cardiovascular toxicity induced by lidocaine in a foal through the administration of intravenous lipids.

Methods

• The subject of the observational case report was an 8-month-old Arabian cross foal, which was being anaesthetized for a surgical procedure.
• The anaesthetic protocol involved maintaining anesthesia with isoflurane in oxygen and administering lidocaine with a loading dose followed by a continuous rate infusion (CRI).
• Although the anaesthetic period was uneventful, a sudden slump in the foal’s mean arterial blood pressure was observed 30 minutes before the expected termination of the procedure, soon after the lidocaine infusion was stopped.
• The electrocardiogram (ECG) signal was lost and there was a significant drop in the end tidal carbon dioxide tension, indicative of a cardiovascular collapse.
• Doctors initiated cardiopulmonary resuscitation manoeuvres, but the administration of epinephrine and atropine did not produce the desired effect.
• A lipid emulsion was then administered, which led to the gradual normalization of the foal’s heart rate and arterial blood pressure.

Results

• The foal regained consciousness three hours later and assumed a sternal position. It reacted responsively and was capable of standing up unassisted 20 hours later.

Conclusions

• The study suggests that intravenous lipid emulsion could be a valuable aid for treating potentially fatal cardiotoxicity caused by lidocaine overdose in foals.
• However, the authors stress further evaluation of more cases to establish the effectiveness of lipid emulsions in treating foals intoxicated with lidocaine.