Prophylactic Use of Lipid Emulsion Therapy After Inadvertent Administration of 0.5% Ropivacaine for a Bier Block: A Case Report.

The Bier block for intravenous regional anesthesia is generally well tolerated, and few complications have been reported. It provides a bloodless surgical field and adequate analgesia when performed correctly. A diluted short-acting local anesthetic such as 0.5% lidocaine is typically used. Our case is a 41-year-old female who presented for endoscopic carpal tunnel release of her right wrist. An accidental injection of 30 mL of 0.5% ropivacaine was given instead of the normal 30 mL of 0.5% lidocaine, with a total tourniquet time of 46 min. Although the maximum safe dose of local anesthetic was not exceeded, lipid emulsion was administered out of an abundance of caution. No neurological or cardiovascular symptoms were reported, and the patient was discharged later that day.