Reactions 1470, p12 - 21 Sep 2013

SBupivacaine

Nystagmus and diplopia due to CSF leakage: casereport

A 32-year-old man developed nystagmus and diplopia dueto CSF leakage following administration of bupivacaine.

The man underwent elective unilateral varicose stripping,and received unilateral spinal anaesthesia with administrationof 2mL of 0.5% bupivacaine via a spinal needle at the L3–L4interface. The surgery and anaesthesia was uneventful.However, 18 hours later, he developed nystagmus anddiplopia while standing, which resolved when resuming thesupine position. Symptoms were thought to be due to CSFleakage. He received caffeine and theophylline. Seven dayslater, diplopia and nystagmus completely resolved.

Author comment: "We reported isolated diplopia andnystagmus without any other subjective symptom after spinalanesthesia. . . We think that the diplopia was likely caused byCSF leakage, resulting in traction on nervus abducens."Basaranoglu G, et al. Isolated transient diplopia and nystagmus after spinalanesthesia. Journal of Anesthesia 27: 643-644, No. 4, Aug 2013. Available from:URL: http://dx.doi.org/10.1007/s00540-013-1575-y - Turkey 803093108

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Reactions 21 Sep 2013 No. 14700114-9954/13/1470-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved