Reactions 1472, p27 - 5 Oct 2013

Mepivacaine

Transient hypotension in an elderly patient: casereport

A 67-year-old woman experienced transient hypotensionwhile receiving mepivacaine. The woman was scheduled toundergo femoral head replacement following left femur neckfracture; during the course of her anaesthesia, an epiduralpuncture was performed and she was catheterised before atest dose of 3mL of mepivacaine 1% was administered [routenot clearly stated]. She subsequently received a further 10mLof mepivacaine 1%, and surgery was commenced.Twelve minutes later, her BP dropped to 79/50mm Hg. Shereceived ephedrine and her BP recovered quickly. The surgerywas completed without any major fluctuations in her BP.

Author comment: The biggest problems concerninganaesthetic management include cardiac dysrhythmia or dropin BP such as bradycardia or atrioventricular blocks caused byautonomic disorder.Maeda Y, et al. Epidural anesthesia for femoral head replacement in aspinocerebellar ataxia patient: A case report. Masui. The Japanese Journal ofAnesthesiology 62: 979-981, No. 8, Aug 2013 [Japanese; summarised from atranslation] - Japan 803093611

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Reactions 5 Oct 2013 No. 14720114-9954/13/1472-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved