[Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports.].
OBJECTIVE
Ropivacaine was introduced in the clinical practice a little more than 10 years ago, and has been associated to low risk for central nervous system and cardiovascular complications. These reports aimed at presenting a case of cardiac arrest and another one of neurological toxicity after accidental intravascular ropivacaine injection during epidural anesthesia.


METHODS
Two patients undergoing cosmetic plastic surgeries were submitted to thoracic epidural anesthesia with 0.5% ropivacaine. After anesthetic injection, one has presented cardiac arrest in asystole and the other had signs of neurological toxicity. Patients were promptly treated and presented fast recovery, in a way that both surgical procedures could be performed.


CONCLUSIONS
The prompt Identification and treatment of the accidental intravascular injection, as well as ropivacaine pharmacological profile, were decisive in both cases for the satisfactory recovery of our patients.
Curtis
Fábio Geraldo
FG
CET/SBA, Departamento de Anestesiologia, FMB, UNESP.
Furlani
Robson
R
Castiglia
Yara Marcondes Machado
YM