Bupivacaine
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Bupivacaine Neurotoxicity manifesting as permanent anterograde amnesia and lymphocytic meningitis: 2 case reports
A case report described a 38-year-old pregnant woman and a 68-year-old woman, who developed neurotoxicity to bupivacaine, which manifested as permanent anterograde amnesia and lymphocytic meningitis. These possible adverse drug reactions were reported to the European Pharmacovigilance Service [dosages not stated; not all routes, times to reactions onsets and outcomes stated]. A 38-year-old woman received epidural bupivacaine during pregnancy for the induction of labour. After 2 hours, she developed disorientation, confusion and anterograde amnesia. CSF analysis revealed lymphocytic pleocytosis, with a normal biochemistry and microbiological results. Cerebral MRI revealed a diffuse, bilateral and symmetrical alteration in both hippocampi. No other parenchymal or vascular alterations were detected. Since no other possible precipitant of the condition could be found, a probable diagnosis of bupivacaine neurotoxicity with bilateral hippocampal involvement was established. Despite the passage of time, the permanent amnesia persisted, with anterograde predominance. A 68-year-old woman received spinal anesthesia with bupivacaine for renal calculi coral surgery. After the intervention, she developed disorientation and anterograde amnesia. CSF analysis revealed lymphocytic pleocytosis, with a normal biochemistry and microbiological results. Cerebral MRI revealed a diffuse, bilateral and symmetrical alteration in both hippocampi. No other parenchymal or vascular alterations were detected. Since no other possible precipitant of the condition could be found, a probable diagnosis of bupivacaine neurotoxicity with bilateral hippocampal involvement was established. Despite the passage of time, the permanent amnesia persisted, with anterograde predominance. Agirre Beitia G, et al. Neurotoxicity after bupivacaine administration: Description of 2 cases. European Journal of Neurology 27 (Suppl. 1): 743 (plus poster) abstr. EPO1346, 803498483 May 2020. Available from: URL: https://onlinelibrary.wiley.com/doi/10.1111/ene.14308 [abstract]
0114-9954/20/1819-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 29 Aug 2020 No. 1819
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