Profound motor blockade with epidural ropivacaine following spinal bupivacaine.
Ropivacaine, a relatively new amide local anaesthetic, reputedly produces less motor block than equivalent doses of bupivacaine, potentially combining high-quality analgesia with the ability to ambulate. We report two cases of prolonged, profound motor block with patient-controlled epidural analgesia using 0.1% ropivacaine, following spinal bupivacaine for Caesarean section. As there was no evidence of inadvertent intrathecal ropivacaine administration or of any neurological injury, we hypothesise that epidural ropivacaine may interact with intrathecal bupivacaine to prolong its effect.
Buggy
D J
DJ
University Department of Anasthesia, Leicester University General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
Allsager
C M
CM
Coley
S
S
D000328:Adult; D000577:Amides / Q000494:pharmacology*; D016058:Analgesia, Patient-Controlled; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000494:pharmacology*; D002585:Cesarean Section; D004357:Drug Synergism; D005260:Female; D006801:Humans; D009068:Movement / Q000187:drug effects*; D011247:Pregnancy; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine