Reactions 1432 - 15 Dec 2012

SRopivacaine

Motor block: case reportA 45-year-old woman developed motor block during

treatment with ropivacaine.The woman presented for rotator cuff repair. She

received surgical anaesthesia using 30mL ropivacaine 0.5%via an ultrasound-guided interscalene block. The surgicalintervention and the nerve block were uneventful.Postoperatively for continuous brachial plexus analgesia,she was treated with an infusion of 0.2% ropivacaine at8 mL/hr via an interscalene catheter. She regained fullmotor function on her first postoperative day. Onpostoperative day 2, she had suprascapular and axillarypain and so the infusion rate of ropivacaine was increasedto 12 mL/hr. She awoke on the next day with completeparalysis of her upper extremity. Examination revealed nomotor strength in her wrist, elbow, or shoulder andcomplete loss of touch sensation throughout her wholeupper extremity. Ultrasound revealed a hypogenic regionsurrounding the nerve trunks between her middle andanterior interscalene muscles.

The woman’s catheter was removed. Her motor functionstarted to recover after 1 hour. She had regained motor andsensory function within 4 hours.

Author comment: "We describe a patient who developeda motor block following an increase in the infusion rate of0.2% ropivacaine via an interscalene catheter."Bolash RB, et al. Unanticipated motor block with brachial plexus analgesia afterincreasing dilute ropivacaine infusion. Journal of Clinical Anesthesia 24: 598-599,No. 7, Nov 2012. Available from: URL: http://dx.doi.org/10.1016/j.jclinane.2011.10.017 - USA 803081252

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Reactions 15 Dec 2012 No. 14320114-9954/10/1432-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved