Respiratory arrest following intrathecal injection of sufentanil and bupivacaine in a parturient.
OBJECTIVE
To present a case of respiratory arrest following the use of intrathecal sufentanil and bupivacaine for combined spinal-epidural anaesthesia in a healthy labouring parturient.


METHODS
A 20-yr-old term parturient received 10 micrograms sufentanil and 2.5 mg bupivacaine intrathecally as part of a combined spinal-epidural technique for labour analgesia. She had received no previous analgesics. Twenty-three minutes after the intrathecal injection she became unresponsive and suffered a respiratory arrest. Resuscitation included manual bag/mask ventilation with oxygen and intravenous naloxone.


CONCLUSIONS
Respiratory arrest is a rare but potentially life-threatening complication associated with the use of intrathecal opioids for labour analgesia. Vigilance in post-procedure patient monitoring is imperative.
Katsiris
S
S
Department of Anaesthesia, Women's College Hospital, University of Toronto, Ontario, Canada.
Williams
S
S
Leighton
B L
BL
Halpern
S
S
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D001049:Apnea / Q000139:chemically induced*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007278:Injections, Spinal; D009270:Naloxone / Q000008:administration & dosage / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D012121:Respiration, Artificial; D012151:Resuscitation; D017409:Sufentanil / Q000008:administration & dosage / Q000009:adverse effects* / Q000037:antagonists & inhibitors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009292:Narcotic Antagonists; D009270:Naloxone; D017409:Sufentanil; D002045:Bupivacaine