Reactions 1467, p9 - 31 Aug 2013

Bupivacaine

Severe pain in an elderly patient: case reportA 68-year-old man developed severe pain after receiving

spinal anaesthesia with bupivacaine.The man underwent autodermic grafting of the left heel

following an infection after internal fixation surgery. Intrathecalisobaric bupivacaine 17.5mg was injected, but as his level ofsensory block was limited to below L2, a second intrathecalinjection of hyperbaric bupivacaine 17.5mg was given. Thissuccessfully extended the region of sensory block up to T4.Three minutes after the second injection, he reported severepain in his left heel. The man was administered IV midazolam,which resolved his pain. His operation proceeded, and noneurological abnormality was seen postoperatively.

Author comment: "We describe an interesting case ofsevere pain induced by spinal anaesthesia".Nishioka K, et al. Severe pain induced by spinal anesthesia in a patient withoutpreceding neuropathy. Journal of Neurosurgical Anesthesiology 24: 512-513, No.4, Oct 2012 [Abstract]. - Japan 803092284

1

Reactions 31 Aug 2013 No. 14670114-9954/13/1467-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved