Respiratory arrest after a caudal injection of bupivacaine.
A 3.5-year-old child with Cornelia de Lange syndrome presenting for orchidopexy and herniotomy received general anaesthesia which was supplemented by a caudal injection of bupivacaine. Shortly after this he had a respiratory arrest with fixed dilated pupils. No cardiovascular system instability was observed. Approximately one hour later the child made a rapid and complete recovery. The possible causes of these events are discussed with particular reference to the potential effects of caudal injections on intracranial pressure.
Lumb
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Department of Anaesthesia, Northwick Park Hospital, Middlesex.
Carli
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F
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D003635:De Lange Syndrome / Q000150:complications; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology*
D002045:Bupivacaine