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[Convulsions induced by ropivacaine after brachial plexus block]
J Recasens Urbez1, C Ferrer Gómez, R Puig Bitria
1Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari Joan XXIII, Tarragona. jru@tinet.org
Revista Espanola De Anestesiologia Y Reanimacion
|December 29, 2004
Summary
Ropivacaine, a local anesthetic, is generally safe for regional blocks. However, rare cases of central nervous system toxicity have been reported following brachial plexus blocks.
Area of Science:
- Anesthesiology
- Neuroscience
Background:
- Ropivacaine is a widely used local anesthetic for regional anesthesia due to its favorable safety profile and sensory nerve selectivity.
- Adverse events associated with ropivacaine are infrequently reported in medical literature.
Observation:
- This report details two distinct cases of central nervous system (CNS) toxicity.
- Both incidents occurred subsequent to brachial plexus blocks administered using 0.75% ropivacaine.
Findings:
- One case involved an axillary brachial plexus block, while the other utilized an infraclavicular approach with nerve stimulation.
- These cases highlight a potential, albeit rare, risk of CNS toxicity even with recommended ropivacaine concentrations and techniques.
Implications:
- Clinicians should remain vigilant for signs of CNS toxicity during and after ropivacaine administration for regional anesthesia.
- Further investigation into the mechanisms and risk factors for ropivacaine-induced CNS toxicity may be warranted.
- These findings underscore the importance of careful patient monitoring following regional blocks.
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