Reactions 1074 - 22 Oct 2005

Bupivacaine

Prolonged neuromuscular blockade following spinalanaesthesia in an elderly patient: case report

A 67-year-old man developed prolonged neuromuscularblockade following spinal anaesthesia with bupivacaine priorto femoropopliteal bypass surgery.

The man received hyperbaric bupivacaine 15mg via a spinalneedle which had been inserted medially at the L4–L5interspace; the bevel was directed caudally duringadministration. Nine hours after spinal anaesthesia initiation,sensory blockade had not regressed from the T10 dermatome,and he was unable to move below his hips. A CT scan showedno anomalies. Approximately 24 hours after anaesthesia, therewas regression bilaterally to a pinprick sensory level, butlower-limb blockade remained and he showed no pain in hisextremities or back. A complete motor and sensory recoverywas noted 29 hours after anaesthesia, and he was discharged5 days postoperatively without pain or neurological deficit.Zeidan A, et al. A case of unusually prolonged hyperbaric spinal anesthesia. ActaAnaesthesiologica Scandinavica 49: 885, No. 6, Jul 2005 - Lebanon 801015469

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Reactions 22 Oct 2005 No. 10740114-9954/10/1074-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved