[Prolonged brachial plexus block with bupivacaine].
A prolonged brachial plexus block with bupivacaine hydrochloride is described. Anaesthesia was induced with 40 ml of a solution made of equal parts of 0.50% bupivacaine hydrochloride and distilled water. Reversal of the motor block began 24 h later. Total recovery was observed 30 h after the onset of anaesthesia. Neurotoxicity of bupivacaine hydrochloride was known to be weak and could not explain the increased length of the block. The dilution of 0.50% bupivacaine hydrochloride resulted in a very low osmolality (141 mosm X kg-1 vs 242 mosm X kg-1 for 0.25% bupivacaine hydrochloride commercial solution). Whether this low osmolality caused nerve lesions was unknown. Postoperative exploration revealed a bilateral slowing down of conduction in the brachial plexus of this 73 year old patient. The importance of this finding could not be assessed.
D000368:Aged; D001917:Brachial Plexus; D002045:Bupivacaine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D013997:Time Factors
D002045:Bupivacaine
Bloc prolongé du plexus brachial à la bupivacaïne.