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[Ropivacaine-induced grand mal convulsion after obturator nerve block]

Mizue Takeuchi1, Yoshihiro Hirabayashi, Kunihisa Hotta

  • 1Department of Anesthesiology and Critical Care Medicine, Jichi Medical School, Tochigi 329 0498.

Masui. the Japanese Journal of Anesthesiology
|November 22, 2005
PubMed

Insights

Accidental intravenous injection of ropivacaine during nerve blockade can cause seizures. Prompt management and understanding ropivacaine plasma concentrations are crucial for patient recovery.

Area of Science:

  • Anesthesiology
  • Clinical Pharmacology

Background:

  • Obturator nerve blockade is a common regional anesthesia technique.
  • Ropivacaine is a local anesthetic used for surgical procedures.

Observation:

  • A patient experienced grand mal convulsions following inadvertent intravenous injection of 150 mg ropivacaine during obturator nerve blockade.
  • Plasma ropivacaine concentrations were measured post-convulsion.

Findings:

  • Peak plasma ropivacaine concentration was estimated at 6.6 microg/mL.
  • Measured concentrations at 15, 32, and 52 minutes were 4.5, 3.5, and 2.9 microg/mL, respectively.
  • The patient recovered without complications.

Implications:

  • This case highlights the risk of systemic toxicity from inadvertent intravenous injection of local anesthetics.
  • Understanding the pharmacokinetics of ropivacaine after accidental intravenous injection is important for managing toxicity.
  • Prompt recognition and supportive care are essential for favorable outcomes in local anesthetic systemic toxicity (LAST).

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