title: [Cerebral seizures during peridural anaesthesia (systemic reaction following bupivacaine 0.75%)].
abstract: In connection with operations on the lower extremities, in the perineum, for vascular surgery, for labour (cesarean section) and for abdominal surgery more than 800 patients were given lumbar epidural anesthesia with plain bupivacaine 0.5% and 100 patients with 0.75% bupivacaine without adrenaline. In one case we observed the dramatic complication of a cerebral convulsion following an epidural analgesia with bupivacaine 0.75% (total dose of 127.5 mg). The convulsion, which occurred to a female patient, can be attributed to possible intravascular injection in correlation with the high concentration of the local analgesic and its fast resorption. This specific complication was treated with 10 mg diazepam which was repeatedly injected intravascular in small doses. Moreover the patient was intubated for a short time and ventilated with pure oxygen in order to avoid a hypoxia of the brain.
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D003975:Diazepam / Q000627:therapeutic use; D004837:Epinephrine; D006801:Humans; D008297:Male; D012640:Seizures / Q000139:chemically induced*
chemical_list: D003975:Diazepam; D002045:Bupivacaine; D004837:Epinephrine
vernacular_title: Zerebraler Krampfanfall bei einer Periduralanaesthesie (Systemische Reaktion nach Bupivacain 0,75%).