Bupivacaine/fentanyl

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Bupivacaine/fentanyl Transient aphonia and facial tingling following intrathecal administration: case report A 31-year-old pregnant woman developed transient aphonia and facial tingling following intrathecal administration of bupivacaine and fentanyl for spinal anaesthesia during caesarean section. The woman was admitted at 37 weeks’ gestation with tenderness at the site of her previous caesarean section scar. Due to the possibility of uterine rupture an urgent caesarean section was performed. Bupivacaine 7.5mg (1.5mL of 0.5% hyperbaric bupivacaine) and fentanyl 25µg were administered via intrathecal injection to achieve level T4 sensory block. A healthy female baby with normal Apgar score was delivered. Subsequently, 13 minutes after administration of bupivacaine and fentanyl, the woman experienced voice weakness and a tingling sensation over her face, immediately followed by complete inability to speak. Rostral spread of bupivacaine and fentanyl to the cerebral cortex affecting the speech area or the cranial nerves was suspected. Sensory block was reassessed and found to be fixed at the T4 level. The woman’s aphonia resolved after 20 minutes and the remainder of the surgery was uneventful. Postoperative neurological examination revealed normal higher function and normal cranial nerve function with no sensory-motor abnormality. Author comment: "We describe a case of transient aphonia and facial tingling after spinal anesthesia with bupivacaine-fentanyl for cesarean section". Ray BR, et al. Intraoperative neurological event during cesarean section under spinal anesthesia with fentanyl and bupivacaine: Case report and review of literature. Journal of Anaesthesiology Clinical Pharmacology 28: 374-377, No. 3, Jul-Sep 2012. Available from: URL: http://dx.doi.org/10.4103/0970-9185.98349 803077453 India

0114-9954/10/1422-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Reactions 6 Oct 2012 No. 1422

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