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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2010 December;76(12):1088-90
Local anesthetic toxicity in interscalene block: clinical series
Nishiyama T. 1, Komatsu K. 2 ✉
1 Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya, Minuma-ku, Saitama, Japan; 2 Department of Critical Care Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
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.