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Inadvertent administration of intravenous ropivacaine in a child
W Y Thong1, V Pajel, S N Khalil
1Department of Anesthesiology, The University of Texas Medical School, 6431 Fannin Street, MSMB 5.182, Houston, TX 77030, USA.
Insights
Accidental intravenous injection of ropivacaine in a child undergoing surgery was managed without complications. This case highlights the importance of careful monitoring and prompt identification of medication administration errors in pediatric anesthesia.
Area of Science:
- Anesthesiology
- Pediatric Intensive Care
- Pharmacology
Background:
- Epidural analgesia with ropivacaine is common in pediatric surgery.
- Accidental intravenous administration of local anesthetics can lead to systemic toxicity.
- Proper identification and management of medication errors are crucial in pediatric care.
Observation:
- A 1-year-old boy received inadvertent intravenous ropivacaine during abdominal surgery.
- The error was identified 2 hours after transfer to the pediatric intensive care unit.
- The child remained stable with normal vital signs and oxygen saturation.
Findings:
- The epidural catheter was connected to the intravenous line, leading to accidental i.v. ropivacaine administration.
- No adverse effects or need for further pain management were observed after catheter removal.
- The patient experienced uneventful recovery without requiring additional analgesia for 10 hours.
Implications:
- This case underscores the importance of vigilant monitoring for medication errors in pediatric anesthesia.
- Prompt recognition and intervention can prevent severe complications from inadvertent intravenous local anesthetic administration.
- Safe pediatric surgical care relies on meticulous attention to drug delivery systems and patient monitoring.
Abstract:
Following abdominal surgery with inhalation anaesthesia and epidural ropivacaine analgesia, inadvertent intravenous (i.v.) administration of ropivacaine occurred in a 1-year-old boy. The child spent 75 min in the postanaesthesia care unit and was transferred to the paediatric intensive care unit. Two hours after transfer, it was noted that the epidural tubing was connected to the peripheral i.v. line. The child remained awake, vital signs were stable, and his oxygen saturation ranged from 96-98% on room air. The epidural catheter was removed. He did not require further pain relief for the next 10 h.