Successful resuscitation following ropivacaine-induced systemic toxicity in a neonate.
A 5-week-old preterm infant was scheduled for inguinal hernia repair. Following induction of general anaesthesia, 10 mg.kg(-1) ropivacaine was injected, accidently, into the caudal space. The infant developed cardiac depression with bradycardia (minimum heart rate 50 beats.min(-1) ), elevated T waves and widening of QRS complexes. Resuscitation by means of external chest compression, intravenous adrenaline and fluid administration was successful. Ropivacaine serum concentrations were obtained at three time points yielding a peak level of 6 μg.ml(-1) 20 min after caudal injection.
Hübler
M
M
Department of Anaesthesiology and Intensive Care Medicine, Technical University Dresden, Germany. matthias.huebler@uniklinikum-dresden.de
Gäbler
R
R
Ehm
B
B
Oertel
R
R
Gama de Abreu
M
M
Koch
T
T
D000577:Amides / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced / Q000628:therapy; D002303:Cardiac Output, Low / Q000139:chemically induced* / Q000628:therapy; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004562:Electrocardiography / Q000187:drug effects; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008508:Medication Errors; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine