Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can induce Seizures while within Therapeutic Window: A Case Report.
BACKGROUND
Hematoma blocks are effective pain management modalities for closed reduction of distal radius fractures. Complications of hematoma blocks are associated with systemic reaction to anesthetic used.


METHODS
We present a case report of an elderly patient who received a hematoma block of lidocaine and bupivacaine for a distal radius fracture and subsequently developed a generalized tonic clonic seizure. The dose of both lidocaine and bupivacaine were well within the suggested dose limit. The episode was self limiting and patient had the cast applied.


CONCLUSIONS
We conclude that hematoma blocks with a combination of anesthetics may decrease the threshold to neurologic complications, especially in elderly patients. Precautions and ready treatment measures should be made available while performing closed reduction.
Department of Orthopaedic Surgery, University of Arizona Medical Center. Tucson, Arizona.
Bobby
B
Dezfuli
Department of Pharmacy, University of Arizona Medical Center. Tucson, Arizona.
Christopher J
CJ
Edwards
Department of Orthopaedic Surgery, University of Arizona Medical Center. Tucson, Arizona.
Gregory L
GL
DeSilva
Hematoma block; bupivacaine; distal radius fracture; lidocaine; seizure