Reactions 1134 - 13 Jan 2007

★Fentanyl/ropivacaine

Deafness (first report with ropivacaine) followingepidural administration: case report

A 29-year-old woman developed sensorineural hearing lossafter receiving fentanyl and ropivacaine for relief of labourpain.

During labour stage II, the woman received epiduralropivacaine [Naropin] 10mL (2 mg/mL) and fentanyl [Fentanyl]0.1mg, incrementally to achieve T10 sensory block. The totalduration of her labour was 7 hours and 15 minutes and, thetreatment was kept at T10 level bilaterally from 4 cm ofcervical effacement until the end of her labour. She presentedto hospital 2 weeks post-delivery with a persistent headache.She reported experiencing a headache and a humming in herright ear with hearing impairment, since delivery.

The woman received autologous epidural blood patchingwhich lead to an immediate relief of her headache; however,her ear symptoms remained. A pure tone audiometry analysisrevealed that she had a peak type sensorineural hearing loss;octave thresholds (0.125–8 kHz) of30–30–10–10–0–10–25 dB (hearing level [HL]) for her rightear. She received betahistidine hydrochloride. Sheexperienced no ear-related problems during follow-up. Sixmonths later, in pure tone audiometry, her right ear octavethresholds were 15–15–5–5–0–10–0 dB (HL) and, 10 monthsafter delivery, they were 0–5–0–5–0–0–5 dB (HL).Hyvarinen A, et al. Sensorineural hearing loss after epidural block for laboranalgesia: a case report. Acta Obstetricia et Gynecologica Scandinavica 85:1403-1405, No. 11, Nov 2006 - Finland 801059472

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of deafness associated withropivacaine. The WHO Adverse Drug Reactions databasecontained no reports of deafness associated with ropivacaine.

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Reactions 13 Jan 2007 No. 11340114-9954/10/1134-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved