ArticleFrontiers in cardiovascular medicine2026
Case Report: Dynamic characteristics of myocardial depression after severe bupivacaine-induced local anesthetic systemic toxicity.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Bupivacaine-induced local anesthetic systemic toxicity (LAST) can lead to severe myocardial depression and circulatory collapse, and some patients may require venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. However, serial and visually interpretable clinical data regarding the dynamic changes in cardiac function, the timing of the nadir, and the recovery trajectory of severe bupivacaine-induced myocardial depression remain limited. Case presentation: A 32-year-old woman at term underwent combined spinal-epidural anesthesia. Shortly after intrathecal administration of 2.0 mL of 0.5% bupivacaine, she developed sacrococcygeal numbness, limb tremors, and bilateral lower-limb convulsions, followed by rapid progression to severe circulatory collapse. Bedside echocardiography revealed markedly impaired left ventricular systolic function, with a left ventricular ejection fraction (LVEF) of approximately 27%. Despite treatment with lipid emulsion and vasoactive agents, hemodynamic stability could not be maintained, and VA-ECMO support was therefore initiated. Serial bedside echocardiography showed that cardiac function reached its nadir 24 h after symptom onset, with a stroke volume of 10.4 mL and an LVEF of 13.2%. Cardiac function then remained at a low-level plateau for the following several days and showed marked recovery approximately 120 h after onset, meeting the criteria for ECMO weaning. After decannulation, cardiac function continued to improve, and the patient was successfully extubated and transferred to the obstetrics department for further management. Conclusions: Severe bupivacaine-induced myocardial depression may be characterized by a delayed functional nadir followed by a reversible recovery process. VA-ECMO can provide effective circulatory support for cardiogenic shock refractory to conventional therapy. Serial bedside echocardiography may help assess the trajectory of cardiac recovery and guide the timing of ECMO weaning.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.