Reactions 1163 - 4 Aug 2007

Bupivacaine/fentanyl

Myoclonus in an infant following intrathecaladministration: case report

A 45-day-old male infant underwent a subarachnoid block athis L5–S1 interspace for anaesthesia prior to bilateral inguinalhernia repair. He received an intrathecal injection of 0.5%bupivacaine 2mg and fentanyl 2.5µg in a volume of 0.46mL. Ashe was turned supine, he developed abnormal, asymmetricalrhythmic flexion and adduction movements in his left arm andthigh, at a frequency of about 20–30 per minute. He receivedoxygen through a face mask. After 4 minutes, his myoclonusspontaneously resolved. Surgery was completed uneventfullyand he was discharged the next day.

Author comment: "[I]ntrathecal bupivacaine appears to bethe most likely cause in this case."Batra YK, et al. Spinal myoclonus associated with intrathecal bupivacaine andfentanyl in an infant. Canadian Journal of Anesthesia 54: 587-588, No. 7, Jul 2007- India 801071951

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Reactions 4 Aug 2007 No. 11630114-9954/10/1163-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved