Reactions 892 - 9 Mar 2002

SRopivacaine

Grand mal seizures following inadvertentintravascular injection in an elderly patient: casereport

A 65-year-old man experienced grand mal seizuresfollowing the inadvertent intravascular injection of ropivacainewhich was being administered for axillary brachial plexusblockade.

The man received 20ml of ropivacaine 0.5% (1.1 mg/kg)injected into the region of his left axilla in 5ml increments overa 1-minute period. His brachial artery was then palpated inorder to insert the needle for a second injection. He suddenlylost consciousness and experienced a grand mal seizure.

General anaesthesia was induced and the man wasintubated. His scheduled surgery was undertaken 30 minuteslater while he was under the general anaesthesia. Three hoursafter receiving ropivacaine, the tracheal tube was removed. Avenous blood sample taken 15 minutes after the injection ofropivacaine revealed a total plasma ropivacaine concentrationof 3.3 mg/L. The initial plasma concentration of ropivacaineimmediately after the injection period was estimated to be5.75 mg/L.Muller M, et al. Grand mal convulsion and plasma concentrations afterintravascular injection of ropivacaine for axillary brachial plexus blockade. BritishJournal of Anaesthesia 87: 784-787, Nov 2001 - Germany 800886444

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Reactions 9 Mar 2002 No. 8920114-9954/10/0892-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved