Reactions 1131 - 9 Dec 2006

Ropivacaine

Sciatic nerve extension following femoral nerveblock: case report

Sciatic nerve extension occurred in a 16-year-old girlreceiving ropivacaine via a femoral catheter during total kneearthroplasty following ablation of an osteosarcoma in her distalleft femur.

Following local anaesthesia, a femoral catheter was placedat a depth of 10cm from the skin and the girl received 0.475%ropivacaine 20mL. She subsequently had a decrease inthermoalgic sensitivity in the area of the femoral and obturatornerves and femoral motor blockade was observed; her surgerylasted 3 hours. During recovery immediately following thesurgical procedure, she received a continuous infusion ofropivacaine 0.2% at a rate of 7 mL/hour Twelve hours later, shehad complete femoral, obturator and sciatic nerve blockade;aortofemoral arteriogram ruled out haematoma-inducedlumbar plexus compression.

The ropivacaine infusion was discontinued and the catheterwas removed. Four hours later, the girl had partial sensitivityand motor power in her lower limb, with complete resolutionwithin 12 hours.

Author comment: "A flow rate of 7 ml/hour infusion forour patient weighing only 40 kg may have resulted inropivacaine accumulation, which could be responsible for thedense sensory and motor block. . . it is possible that ourpatient might have had a subclinical neurotoxicity from herprevious chemotherapy."Cornet C, et al. Sciatic nerve extension complicating continuous femoral blockade.Anaesthesia and Intensive Care 34: 684-685, No. 5, Oct 2006 - France 801051601

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Reactions 9 Dec 2006 No. 11310114-9954/10/1131-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved