Reactions 824 - 21 Oct 2000

Bupivacaine

Unconsciousness following intrathecaladministration: case report

A 25-year-old woman undergoing caesarean sectionbecame unconscious after receiving bupivacaine for spinalanaesthesia.

The parturient received 2ml of 0.5% heavy bupivacaineintrathecally for spinal anaesthesia 20 minutes beforeundergoing caesarean section. She experienced a singletransient episode of hypotension 5 minutes later, which wastreated with ephedrine. At the time of delivery, she becameunconscious; she did not respond to verbal or deeply painfulstimuli. She subsequently experienced a transient episode ofapnoea, for which she received ventilation. She resumedspontaneous ventilation 1 minute later.

The woman began responding to deep pain 10 minutes afterthe onset of unconsciousness. Her degree of consciousnessprogressively increased and she opened her eyes 1 hour afterthe incident began. She was fully alert 30 minutes later.

The woman experienced dizziness and a postural frontalheadache 24 hours after bupivacaine administration. Herheadache resolved after treatment with an epidural bloodpatch. She was asymptomatic when she was discharged 1week after the event.Chan YK, et al. Loss of consciousness following spinal anaesthesia for caesareansection. British Journal of Anaesthesia 85: 474-476, Sep 2000 -Malaysia 800841992

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Reactions 21 Oct 2000 No. 8240114-9954/10/0824-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved