title: Local anesthetic toxicity in interscalene block: clinical series.
abstract: We experienced two cases of local anesthetic toxicity by interscalene block. A 62-year-old man received interscalene block with lidocaine 1% 30 mL and bupivacaine 0.25% 20 mL under light sedation followed by general anesthesia. He was not awake at one hour after surgery with his pupils dilated. Three hours after interscalene block, he became awake with no complication. A 73-year-old female received interscalene block with lidocaine 1% 15 mL and ropivacaine 0.75% 15 mL under light sedation. After the injection, a catheter was inserted 5 cm. About 7-8 min after catheter insertion, generalized tonic seizure occurred. Seizure stopped in two min after anesthesia induction. She had no complication after surgery. These two cases showed neurological toxicity by interscalene block with lidocaine and bupivacaine or with ropivacaine without hemodynamic complication.
authors.affiliation: Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya, Minuma-ku, Saitama, Japan. nishit-tky@umin.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Nishiyama
authors.forename: K
authors.initials: K
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000577:Amides / Q000009:adverse effects*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D019637:Orthopedic Procedures; D011680:Pupil / Q000187:drug effects; D000077212:Ropivacaine; D012640:Seizures / Q000139:chemically induced; D012785:Shoulder Joint / Q000601:surgery
chemical_list: D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine; D002045:Bupivacaine