Seizures after a Bier block with clonidine and lidocaine.
A 47-yr-old man with history of complex regional pain syndrome type 1 underwent an IV Bier block with a mixture of lidocaine and clonidine. The tourniquet was deflated after 60 min, and approximately 10 min later he presented with complex partial seizures. The possible mechanisms for this are discussed, and the effects of clonidine, lidocaine, and the mixture of both are reviewed, as are four additional published cases reporting seizures after the administration of clonidine.
Massachusetts General Hospital Pain Center, WACC-324, Massachusetts General Hospital, 15 Parkman Street, Boston, MA 02114, USA. sahmed@partners.org
Shihab U
SU
Ahmed
Ricardo
R
Vallejo
E Daniela
ED
Hord
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D003000:Clonidine / Q000009:adverse effects*; D017029:Epilepsy, Complex Partial / Q000139:chemically induced*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D012019:Reflex Sympathetic Dystrophy / Q000150:complications
D000316:Adrenergic alpha-Agonists; D000779:Anesthetics, Local; D008012:Lidocaine; D003000:Clonidine