Ropivacaine
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Ropivacaine Sciatic nerve extension following femoral nerve block: case report Sciatic nerve extension occurred in a 16-year-old girl receiving ropivacaine via a femoral catheter during total knee arthroplasty following ablation of an osteosarcoma in her distal left femur. Following local anaesthesia, a femoral catheter was placed at a depth of 10cm from the skin and the girl received 0.475% ropivacaine 20mL. She subsequently had a decrease in thermoalgic sensitivity in the area of the femoral and obturator nerves and femoral motor blockade was observed; her surgery lasted 3 hours. During recovery immediately following the surgical procedure, she received a continuous infusion of ropivacaine 0.2% at a rate of 7 mL/hour Twelve hours later, she had complete femoral, obturator and sciatic nerve blockade; aortofemoral arteriogram ruled out haematoma-induced lumbar plexus compression. The ropivacaine infusion was discontinued and the catheter was removed. Four hours later, the girl had partial sensitivity and motor power in her lower limb, with complete resolution within 12 hours. Author comment: "A flow rate of 7 ml/hour infusion for our patient weighing only 40 kg may have resulted in ropivacaine accumulation, which could be responsible for the dense sensory and motor block. . . it is possible that our patient might have had a subclinical neurotoxicity from her previous chemotherapy." Cornet C, et al. Sciatic nerve extension complicating continuous femoral blockade. 801051601 Anaesthesia and Intensive Care 34: 684-685, No. 5, Oct 2006 - France
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Reactions 9 Dec 2006 No. 1131
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