Reactions 1506, p9 - 21 Jun 2014

Bupivacaine/levobupivacaine

Shivering: 2 case reportsA randomised study of 60 ASA grade I-II patients,

18–65 years of age, undergoing knee arthroscopy under spinalanaesthesia identified two patients who developed shiveringafter receiving bupivacaine or levobupivacaine, respectively[ages and sexes not stated]. One patient received 12.5mg ofisobaric bupivacaine, while the other patient received 12.5mgof isobaric levobupivacaine. They both developed minorshivering [duration of treatments to reaction onset not stated].Symptoms resolved in both patients within 24 hours.

Author comment: "Systemic toxicity of local anaestheticsmay occur as a consequence of unwanted intravascular orintrathecal injection, or after the administration of anexcessive dose of these drugs. Systemic toxicity of localanaesthetic drugs primarily involves the central nervoussystem (CNS) and then the cardiovascular system." "Despitesome studies providing evidence that levobupivacaine is lessneurotoxic than bupivacaine, we found no differencesbetween both agents at equivalent doses."Del-Rio-Vellosillo M, et al. Central nervous system toxicity of local anaesthetics:Levobupivacaine and bupivacaine in spinal anaesthesia. European Journal ofNeurology 21 (Suppl. 1): 410 abstr. PP1080, May 2014 - Spain 803104983

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Reactions 21 Jun 2014 No. 15060114-9954/14/1506-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved