Bupivacaine drug-induced liver injury: a case series and brief review of the literature.
Bupivacaine is an established and efficacious anesthetic that has become increasingly popular in postoperative pain management. However, there is limited literature regarding the potential for bupivacaine-induced delayed liver toxicity. Describe cholestasis as a potential adverse reaction of bupivacaine infusion into a surgical wound. Retrospective review of patients' medical records. We report the cases of 3 patients with new onset of cholestatic injury after receiving bupivacaine infusion for postoperative herniorrhaphy pain management. All patients had negative serologic workups for other causes of liver injury. All patients achieved eventual resolution of their liver injury. Bupivacaine-induced liver injury should be on the differential of individuals presenting with jaundice and cholestasis within a month of infusion via a surgically placed catheter of this commonly used anesthetic.
Department of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: chintamanenip@upmc.edu.
Preethi
P
Chintamaneni
Division of Liver and Transplantation Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Heather L
HL
Stevenson
Department of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Shahid M
SM
Malik
D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects*; D001706:Biopsy; D002045:Bupivacaine / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000473:pathology; D002779:Cholestasis / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008111:Liver Function Tests / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged
D000779:Anesthetics, Local; D002045:Bupivacaine
Analgesics; Bupivacaine; Cholestasis; Drug induced liver injury