Bupivacaine-induced seizures and ventricular fibrillation in a 13-year-old girl undergoing wound debridement.
Bupivacaine is a commonly used local anesthetic in dental, ophthalmologic, and simple surgical procedures. Its current popularity derives from its potency and relatively long half-life. Widespread use of bupivacaine has resulted in sometimes severe adverse reactions when significant systemic absorption has occurred. This report documents a life-threatening event following use of bupivacaine, briefly reviews its neurotoxic and cardiotoxic effects, and raises questions about current management strategies when toxicity occurs.
Yan
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Department of Pediatrics, Children's Hospital and Medical Center and the University of Washington, Seattle, USA.
Newman
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D000208:Acute Disease; D000293:Adolescent; D000779:Anesthetics, Local / Q000009:adverse effects*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D002045:Bupivacaine / Q000009:adverse effects*; D003646:Debridement; D003975:Diazepam / Q000009:adverse effects / Q000627:therapeutic use; D004357:Drug Synergism; D005260:Female; D006801:Humans; D012151:Resuscitation; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000628:therapy; D014947:Wounds and Injuries / Q000601:surgery*
D000779:Anesthetics, Local; D000927:Anticonvulsants; D003975:Diazepam; D002045:Bupivacaine