Reactions 929 - 23 Nov 2002

SBupivacaine/sufentanil

Respiratory arrest: case reportA 22-year-old woman experienced respiratory arrest after

receiving sufentanil and bupivacaine during anaesthesia for acaesarean section.

Following lumbar puncture at the L3–4 position, the womanhad received a slow injection of sufentanil 10µg (2ml) followedby 0.1% bupivacaine 10mg (10ml). Eight minutes later, shebecame unrousable and apnoeic; 100% oxygen was given andspontaneous respiration resumed after 3 minutes. After sheregained consciousness, pin-prick testing showed sensory lossto T4. She had no signs of motor weakness or flaccidity of herupper extremities and her pupils were pinpoint; nopostoperative complications occurred.

Author comment: ‘We believe the combination of thevolume of drugs used and the sequence in which they wereadministered may have been important in this context . . . Thisrelatively large bolus of local anaesthetic solution may havedisplaced CSF [cerebrospinal fluid], causing bulk flow ofsufentanil in a rostral direction.’Kehl F, et al. Respiratory arrest during caesarean section after intrathecaladministration of sufentanil in combination with 0.1% bupivacaine 10 ml.Anaesthesia and Intensive Care 30: 698-699, Oct 2002 - Germany 800921170

1

Reactions 23 Nov 2002 No. 9290114-9954/10/0929-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved