Reactions 759 - 10 Jul 1999

★Bupivacaine

First report of metallic taste: case reportLocal anaesthesia with bupivacaine was associated with the

development of a metallic taste in a 48-year-old woman.The woman was hospitalised with scleroderma necrosis of

her finger. She was treated with ciprofloxacin and clindamycinand a 5 ml/hour infusion of bupivacaine 0.25% was given viaan axillary catheter for ganglionic blockade of the affectedfinger.

Within 1 day of starting treatment with bupivacaine, thewoman developed an intolerable metallic taste in her mouth.The bupivacaine infusion was stopped for several hours andthe metallic taste rapidly resolved. The next day, the infusionwas restarted at a rate of 3 ml/hour. She awoke 4 hours laterwith a metallic taste in her mouth; she did not report any tastedisturbances later that afternoon. The next morning, she againreported a metallic taste. The bupivacaine infusion rate wasdecreased to 2 ml/hour and the metallic taste resolved.

That evening, the woman experienced increased pain in herfinger so the bupivacaine infusion rate was increased to 3ml/hour. The next day, the rate was increased again to 4ml/hour and the degree of metallic taste increased. Thebupivacaine infusion was continued for 4 more days (4ml/hour) and, during this time, the metallic taste improved.Lo AB. Bupivacaine-induced metallic taste. Journal of Pharmacy Technology 15:54-55, Mar-Apr 1999 - Canada 800779562

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of metallic taste or othertaste disorders associated with bupivacaine.

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Reactions 10 Jul 1999 No. 7590114-9954/10/0759-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved