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Horner’s syndrome in an infant following paravertebral administration: case report A 15-month-old, 11kg boy received thoracic paravertebral analgesia with a mixture of 0.5% levobupivacaine, 1% lidocaine and epinephrine, with an initial dose of 0.5 mL/kg followed by hourly supplements of 0.2 mL/kg, during an elective right axillary haemolymphangiectomy. After completion of this procedure, he received a continuous paravertebral infusion of a mixture of 0.125% levobupivacaine and clonidine 1 µg/mL, at 0.2 mL/kg/hour. At breakfast 48 hours later, signs of a right Horner’s syndrome were noted by his parents and hospital staff [treatment duration to reaction onset not clearly stated]. The infusion was stopped immediately; over the following 4 hours, his symptoms progressively resolved. Over the following 2 days, he received rescue analgesia with nalbuphine and acetaminophen. Ludot H, et al. Transient Horner’s syndrome in an infant after continuous upper thoracic paravertebral analgesia. Pediatric Anesthesia 18: 86-87, No. 1, Jan 2008 801079962 France

» Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of Horner’s syndrome associated with clonidine. The WHO Adverse Drug Reactions database did not contain any reports of Horner’s syndrome associated with clonidine.

0114-9954/10/1188-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Reactions 9 Feb 2008 No. 1188