Reactions 1027 - 13 Nov 2004

SRopivacaine

Peripheral nerve disorders associated with epiduralanalgesia: case report

A 51-year-old man developed sensory polyneuropathy afterepidural administration of ropivacaine for postoperativeanalgesia.

The man, who had a history of hypertension and type 2diabetes mellitus, underwent a radical prostatectomy andenterocystoplasty under general anaesthesia. Postoperatively,he received an epidural bolus dose of 0.75% ropivacaine and,1 hour later, a continuous epidural 0.2% ropivacaine infusionwas started at a rate of 5 mL/hour. The rate of administrationwas increased to 10 mL/hour 10 hours later and he receivedproparacetamol; ropivacaine was infused for a further72 hours. Eight hours after the infusion was stopped, hedeveloped a severe bilateral burning sensation and pain on histhighs and back that spread to his legs and feet. He alsodeveloped paraesthesias of his thighs and legs that wereexacerbated by movement.

The man received proparacetamol and SC morphine overthe next 6 days, without symptomatic improvement.Electromyography revealed sensory polyneuropathy in hisupper and lower limbs and bilateral abolition of sensorypotential in several nerves. Gabapentin was started; his painimproved, but paraesthesias persisted and examinationrevealed abolition of osteotendinos reflexes in his lower limbs.At 8 weeks’ follow-up, pain and paraesthesias had improved,but he continued to experience lower limb discomfort.Subsequent electromyography was unchanged.Al-Nasser B. Toxic effects of epidural analgesia with ropivacaine 0.2% in adiabetic patient. Journal of Clinical Anesthesia 16: 220-223, No. 3, May 2004 -France 807217786

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Reactions 13 Nov 2004 No. 10270114-9954/10/1027-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved