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Bupivacaine/fentanyl Myoclonus in an infant following intrathecal administration: case report A 45-day-old male infant underwent a subarachnoid block at his L5–S1 interspace for anaesthesia prior to bilateral inguinal hernia repair. He received an intrathecal injection of 0.5% bupivacaine 2mg and fentanyl 2.5µg in a volume of 0.46mL. As he was turned supine, he developed abnormal, asymmetrical rhythmic flexion and adduction movements in his left arm and thigh, at a frequency of about 20–30 per minute. He received oxygen through a face mask. After 4 minutes, his myoclonus spontaneously resolved. Surgery was completed uneventfully and he was discharged the next day. Author comment: "[I]ntrathecal bupivacaine appears to be the most likely cause in this case." Batra YK, et al. Spinal myoclonus associated with intrathecal bupivacaine and fentanyl in an infant. Canadian Journal of Anesthesia 54: 587-588, No. 7, Jul 2007 801071951 - India

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