Reactions 1323 - 16 Oct 2010

SBupivacaine

Heart arrest: case reportA 60-year-old man received an ultrasound guided

injection of 0.5% bupivacaine to achieve left stellateganglion block due to chronic facial pain; the needle waspositioned below the prevertebral fascia andbupivacaine 10mL was administered (5 x 2mL bolusinjections). He developed mouth and eye twitchingimmediately following the procedure; loss ofconsciousness and cyanosis ensued. He experienced ageneralised tonic-clonic seizure, and airway obstructionresulted with loss of palpable pulse. He had previouslyreceived several uneventful stellate ganglion blocks. Hewas successfully resuscitated, and returned home the nextday. It was presumed that the seizures resulted inrespiratory then cardiac arrest.

Author comment: "The likely cause of the complicationwas injection of local anaesthetic into the vertebral artery".Rastogi S, et al. Cardiac arrest following stellate ganglion block performed underultrasound guidance. Anaesthesia 65: 1042, No. 10, Oct 2010. Available from:URL: http://dx.doi.org/10.1111/j.1365-2044.2010.06487.x - UnitedKingdom 803042195

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Reactions 16 Oct 2010 No. 13230114-9954/10/1323-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved