Ultrasound-guided trigger point injections

Cardiac arrest in a 36 year-old after trigger point injection with lidocaine: Case report

A typical vasovagal response is characterized by bradycardia and paradoxical vasodilation. It is oftentimes self-limited and spontaneously reversible; however, severe cases can result in significant complications. This report describes a case of profound vasovagal syncope with subsequent cardiac arrest in the setting of receiving a trigger point injection. This patient presented to an outpatient clinic for ultrasound-guided left trapezius, levator scapulae, and rhomboid trigger point injections for relief of myofascial pain. One milliliter of 1% lidocaine was injected into the first trigger point when she stated she felt dizzy before becoming unresponsive without palpable peripheral pulses. The patient regained consciousness following cardiopulmonary resuscitation (CPR). Considering the frequency of office based pain procedures, it is important to recognize the potential serious complications associated with procedures frequently thought to be benign.