Reactions 710 - 18 Jul 1998

Ropivacaine

Seizure following inadvertent intravenousadministration: case report

A 23-year-old woman experienced a seizure after she wasinadvertently given intravenous instead of extraduralropivacaine prior to postpartum tubal ligation; she received atotal dose of ropivacaine 120mg, injected in increments overan 11-minute period.

Initially, the woman received 15mg (2ml) of ropivacaine.However, there were no signs of subarachnoid block and shewas given further injections of ropivacaine 30mg (4ml). Aftershe had received only 15mg of the fourth 30mg injection, sheclosed her eyes and said that she felt nervous.

Within a few seconds, the woman experienced a generalisedtonic-clonic seizure that lasted approximately 1 minute; shealso had sinus tachycardia. She recovered spontaneously.Inspection of the extradural catheter revealed blood. She wasdischarged the next day and the tubal ligation wassubsequently performed, without sequelae.

Author comment: ‘This case report demonstrates therelative absence of prodromal symptoms of CNS toxicity afteri.v injection of a relatively large dose of ropivacaine and theabsence of serious manifestations of cardiotoxicity.’Abouleish EI, et al. Ropivacaine-induced seizure after extradural anaesthesia.British Journal of Anaesthesia 80: 843-844, Jun 1998 - USA 800686189

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Reactions 18 Jul 1998 No. 7100114-9954/10/0710-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved