Reactions 417 - 5 Sep 1992

Bupivacaine

Seizures and ventricular tachycardia in a neonateand in children: 3 case reports

Seizures developed in 2 girls and 1 newborn boy (3.89kg)following prolonged caudal epidural infusions of bupivacaineto treat postoperative pain; arrhythmia also developed in theneonate.

The patients had also received bupivacaine for generalanaesthesia during surgery. A continuous infusion ofbupivacaine 1.67-2.5 mg/kg/h with epinephrine was initiated1.5-4h after the last intraoperative dose of bupivacaine.

Seizures developed in the 8 and 4-year-old girls 25 and 34h,respectively after the bupivacaine infusion was started.Bupivacaine was discontinued. Seizures resolved with IVdiazepam and there were no neurological sequelae.

Seizures and ventricular tachycardia developed in theneonate 10 hours after initiation of the infusion. Bupivacainewas discontinued. Various drugs were tried unsuccessfully totreat the seizures and ventricular tachycardia; however, thesecomplications resolved with IV diazepam and phenytoin. [Seealso Views and Reviews, p4].McCloskey JJ, et al. Bupivacaine toxicity secondary to continuous caudal epiduralinfusion in children. Anesthesia and Analgesia 75: 287-290, Aug 1992 -USA 800152169

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Reactions 5 Sep 1992 No. 4170114-9954/10/0417-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved