Reactions 1188 - 9 Feb 2008

★Clonidine/levobupivacaine/lidocaine

Horner’s syndrome in an infant followingparavertebral administration: case report

A 15-month-old, 11kg boy received thoracic paravertebralanalgesia with a mixture of 0.5% levobupivacaine, 1%lidocaine and epinephrine, with an initial dose of 0.5 mL/kgfollowed by hourly supplements of 0.2 mL/kg, during anelective right axillary haemolymphangiectomy. Aftercompletion of this procedure, he received a continuousparavertebral infusion of a mixture of 0.125% levobupivacaineand clonidine 1 µg/mL, at 0.2 mL/kg/hour. At breakfast48 hours later, signs of a right Horner’s syndrome were notedby his parents and hospital staff [treatment duration to reactiononset not clearly stated]. The infusion was stoppedimmediately; over the following 4 hours, his symptomsprogressively resolved. Over the following 2 days, he receivedrescue analgesia with nalbuphine and acetaminophen.Ludot H, et al. Transient Horner’s syndrome in an infant after continuous upperthoracic paravertebral analgesia. Pediatric Anesthesia 18: 86-87, No. 1, Jan 2008 -France 801079962

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of Horner’ssyndrome associated with clonidine. The WHO Adverse DrugReactions database did not contain any reports of Horner’ssyndrome associated with clonidine.

1

Reactions 9 Feb 2008 No. 11880114-9954/10/1188-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved