An unusual cause of seizures during subarachnoid anesthesia in a patient undergoing transurethral resection of the prostate: a case report.
A 73-year-old, ASA I patient scheduled for transurethral resection of the prostate under subarachnoid anesthesia received, prior to the beginning of the surgery, intravenous imipenem/cilastatin 1 g for a urinary infection with multiresistant Escherichia coli. The patient developed seizures during the surgical procedure. Central nervous toxicity of imipenem/cilastatin might have been the cause of the seizures. After appropriate management, the patient recovered well and was discharged without complications. The differential diagnosis between systemic toxicity of local anesthetics and imipenem-related seizures is discussed.
Galante
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Department of Anesthesia and Intensive Care, Ospedali Riuniti University Hospital, Foggia, Italy. dario.galante@tin.it
D000368:Aged; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D019072:Antibiotic Prophylaxis; D015377:Cilastatin / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D003937:Diagnosis, Differential; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D011229:Preanesthetic Medication; D011470:Prostatic Hyperplasia / Q000601:surgery; D012640:Seizures / Q000139:chemically induced*; D013346:Subarachnoid Space; D020728:Transurethral Resection of Prostate
D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D015377:Cilastatin; D015378:Imipenem