Reactions 1330 - 4 Dec 2010

SRopivacaine

Systemic toxicity treated with soya-oil emulsion:case report

A 27-year-old woman developed systemic toxicityfollowing ropivacaine administration to achieve a brachialplexus block. She was successfully treated with soya-oilemulsion [Intralipid].

The woman received a ropivacaine 0.75% 40mL injectioninto her deltoid muscle. After 5 minutes she experiencedgeneralised convulsions and her consciousness level fell toE1M1V1 on the Glasgow Coma Scale.

The woman was given oxygen and midazolam whichcontrolled her convulsions. At the same time she receivedIV soya-oil emulsion 20% at 200 mg/mL. After a bolus of100mL (1.5 mL/kg), a further 400mL was infused over1.5 hours. She was given respiratory support and becameresponsive after 10 minutes. After 2.5 hours she underwentsurgery with a general anaesthetic and successful plexusblock.Ter Horst MT, et al. Antidote for intoxication due to local anesthetics: Newapplication of fat emulsion for intravenous administration. Nederlands Tijdschriftvoor Geneeskunde 154: 1822-1825, No. 39, 2 Oct 2010 [Dutch; summarised froma translation] - Netherlands 803044273

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Reactions 4 Dec 2010 No. 13300114-9954/10/1330-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved