Reactions 1341 - 5 Mar 2011

Bupivacaine

Spinal myoclonus: case reportA 35-year-old woman developed spinal myoclonus

following administration of bupivacaine for spinalanaesthesia.

The woman had a history of involuntary leg movementswithin 3 hours of spinal anaesthesia with bupivacaine. Themovements had resolved spontaneously, but no specificdiagnosis had been made. One year later, she was admittedfor surgical treatment of tendonitis. She underwent spinalanaesthesia with 9mg of 0.5% heavy bupivacaine [MarcaineSpinal 0.5% Heavy] and epinephrine [adrenaline] via a 25Gspinal needle. Approximately 100 minutes afteranaesthesia, she experienced involuntary myoclonicmovements of both arms and legs.

Although a slight improvement was seen followingtreatment with midazolam and clonazepam, themyoclonus persisted. A diagnosis of spinal myoclonus wasmade the woman received another dose of clonazepam.Four hours later, the myoclonus had resolved completely.No abnormal neurological findings were seen the followingday. At 1-month follow-up, she had not experienced anyrecurrence of spinal myoclonus.

Author comment: "Because our patient had no specificdisease history and had unremarkable neurologic andlaboratory findings, the cause of spinal myoclonus was likelyspinal anesthesia with bupivacaine."Lee JJ, et al. Recurrent spinal myoclonus after two episodes of spinal anesthesia ata 1-year interval. Korean Journal of Anesthesiology 59 (Suppl.): S62-S64, 31 Dec2010. Available from: URL: http://dx.doi.org/10.4097/kjae.2010.59.s.s62 - SouthKorea 803050207

1

Reactions 5 Mar 2011 No. 13410114-9954/10/1341-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved