SUCCESSFUL RESUSCIТATION AND REHABILIТAТION OF А CHILD FROM ТНЕ STATE OF CLINICAL DEATH (CARDIAC ARREST), CAUSED ВУ NOVOCAIN INTOXICATION

Cases of cardiac death (cardiac arrest) caused by local anesthesia with novocain аrе rarity. According tо Waters Jimms - 1944, clinical death accidents during lосаl anesthesia аrе encountered in 0,106%. They аrе mostly casually related to hypersensibility and intolerance to novocain. Exceedingly rаrе аrе the instances of cardiac arrest, caused bу novocain intoxication.Recently, we had the possibility to observe resuscitation of а child from clinical death bу novocain intoxication, as well as its subsequent successful rehabilitation.Оn 12 September, 1964 in the Naval Hospital at Varna, the patient N. J. J., 9-year-old schoolboy (case history 845/12.IX.1963) was admitted  for tonsillectomy.  Erroneously, peritonsillar anesthesia was carried out with 10 % instead of 1 % Novocain solution, totaling a quantity of 40 ml. About 5 min, after the anesthesia the child sustains heavy epileptiform fits with loss of consciousness. Breathing is gradually delayed, becomes superficial and in 1-2 minutes it ceases completely. Several minutes later heart activity is also arrested. Dilatation of the pupils is established and reaction to light disappears. The eyeballs are softened. Full areflexia (absence of reflexes) occurs. Epinephrine, luminal, caffeine, cardiazol, plegomazin, nor-epinephrine and cortisone are administered by injection. On the 4-5th minute of cardiac arrest, the child is intubated, and after further 5 min, leftside thoracotomy and direct heart massage performed. On opening the chest cavity, the heart is found relaxed in diastole, filled up with blood. The wound is not bleeding. After nearly 40 compressions (pumping), independent cardiac activity is resumed. Blood pressure is increased up to 120/80mm of Mercury column, the pupilis are contracted. Pupillary reaction to light is restored. An hour later spontaneous breathing occurs, initially weaker and superficial (28-30 respitations per minute) and subsequently, though speeded up – with adequate depth and effectiveness. Twenty four hours later extubations is resorted to and tracheostomy applied. The operative wound of the thorax heals by first intention and no pulmonary complications occur