Reactions 1093 - 18 Mar 2006

Bupivacaine

Transient aphonia: case reportDuring arthroscopy, while under general anaesthesia, a

58-year-old woman received 0.5% bupivacaine 20mL withepinephrine [adrenaline] via a catheter implanted into her leftshoulder joint. She then received an infusion of the samesolution at a rate of 2 mL/hour. She reported no painpostoperatively but, 36 minutes later, developed sudden-onsetaphonia. On examination, she was able to follow commandsand communicate by writing, but was unable to speak.Neurological examination and imaging studies wereunremarkable. Her aphonia began to improve afterapproximately 7 hours and had resolved completely 1 hourlater.

Author comment: "The resolution of aphonia within theexpected duration of bupivacaine block, as well as absence ofobvious neurological findings during diagnostic work-up,suggests a possible underlying mechanism of laryngeal nerveparalysis from the local anesthetic bolus."Haile DT, et al. Transient postoperative aphonia following instillation ofbupivacaine into the shoulder joint. Canadian Journal of Anesthesia 53: 212-213,No. 2, 1 Feb 2006 - USA 801033863

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Reactions 18 Mar 2006 No. 10930114-9954/10/1093-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved