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Seizure induced by ropivacaine.
D Y Bisschop1, J P Alardo, B Razgallah
1Centre Régional de Pharmacovigilance, Hôpital Maison Blanche, Reims, France.
The Annals of Pharmacotherapy
|March 23, 2001
Summary
Ropivacaine, a local anesthetic, may cause seizures. This case report highlights a seizure developing after epidural ropivacaine administration during a cesarean section, emphasizing the need for clinical awareness.
Area of Science:
- Anesthesiology
- Neurology
- Obstetrics
Background:
- Local anesthetics, such as ropivacaine, are widely used for regional anesthesia.
- While generally considered safe, central nervous system (CNS) toxicity, including seizures, can occur.
- Ropivacaine is a relatively new anesthetic agent with a reported lower risk of CNS toxicity compared to older agents.
Observation:
- A 26-year-old woman undergoing cesarean section received a total dose of 279 mg of ropivacaine epidurally over five hours.
- Following administration, the patient exhibited oculogyric movements and slurred speech.
- These symptoms were followed by convulsions affecting the face and upper limbs.
Findings:
- The patient's seizure event occurred after epidural ropivacaine administration.
- The Naranjo probability scale suggested a possible causal link between ropivacaine and the seizure.
- This case adds to the limited but growing reports implicating ropivacaine in seizure activity.
Implications:
- Clinicians must remain vigilant for seizure as a potential adverse effect of ropivacaine.
- This case underscores the importance of monitoring patients for neurological symptoms during and after ropivacaine administration.
- Further research may be warranted to fully elucidate the neurotoxicity profile of ropivacaine.