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[Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports.]
Fábio Geraldo Curtis1, Robson Furlani, Yara Marcondes Machado Castiglia
1CET/SBA, Departamento de Anestesiologia, FMB, UNESP.
Background And Objectives:
Ropivacaine was introduced in the clinical practice a little more than 10 years ago, and has been associated to low risk for central nervous system and cardiovascular complications. These reports aimed at presenting a case of cardiac arrest and another one of neurological toxicity after accidental intravascular ropivacaine injection during epidural anesthesia.
Case Reports:
Two patients undergoing cosmetic plastic surgeries were submitted to thoracic epidural anesthesia with 0.5% ropivacaine. After anesthetic injection, one has presented cardiac arrest in asystole and the other had signs of neurological toxicity. Patients were promptly treated and presented fast recovery, in a way that both surgical procedures could be performed.
Conclusions:
The prompt Identification and treatment of the accidental intravascular injection, as well as ropivacaine pharmacological profile, were decisive in both cases for the satisfactory recovery of our patients.
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