Reactions 1262 - 25 Jul 2009

★Levobupivacaine

First report of hiccups following epiduralinjection: case report

A 30-year-old woman developed acute transient hiccupsafter receiving epidural levobupivacaine for labouranalgesia.

The woman, who presented in labour with a twinpregnancy at 35 weeks gestation, received a 5mL loadingdose of 0.125% levobupivacaine via epidural catheter. Shedeveloped hiccups within a few minutes.

A bilateral sensory block to T10 was produced withfractionated doses of levobupivacaine with alfentanil. Aninfusion was initiated of 0.1% levobupivacaine withalfentanil, at a rate of 10 mL/hour. The hiccups resolvedspontaneously after about 1 hour. Due to breakthroughpain 6 hours later, an additional 5mL of 0.25%levobupivacaine, plus 2mL from the pump, was given. Thewoman developed hiccups within a few minutes, whichlasted for about 2 hours. An emergency caesarean wasperformed for the delivery of the second twin, during whichshe received 5mL of 0.25% levobupivacaine withdiamorphine [heroin], via epidural, for postoperative painrelief. She did not experience any hiccups following theprocedure.Kanniah SK. Acute transient hiccups after epidural injection of levobupivacaine.International Journal of Obstetric Anesthesia 18: 193-194, No. 2, Apr 2009 -Northern Ireland 801146707

» Editorial comment: A search of AdisBase, Medline,Embase and the WHO ADR database (WHO-ART) did notreveal any previous case reports of hiccups associated withlevobupivacaine.

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Reactions 25 Jul 2009 No. 12620114-9954/10/1262-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved