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Ropivacaine/triamcinolone Long-lasting nerve block and common peroneal nerve palsy: case report A 43-year-old woman experienced a long-lasting nerve block and common peroneal nerve palsy following administration of ropivacaine and triamcinolone for nerve block. The woman was hospitalised due to grade II osteoarthritis and scheduled to undergo knee prolotherapy and genicular nerve injection. She was put into position, and using the outof-plane approach, the needle was advanced with the trajectory adjusted to lie in proximity to the target (genicular nerves target point). Once proper needle tip placement was confirmed, a 2.5mL solution containing 10mg triamcinolone and 0.2% preservative-free ropivacaine was injected for each genicular nerve. However, approximately 20 minutes later, she reported decreased force of her left greater toe. The weakness gradually became more severe, expanding into the entire territory of the common peroneal nerve. Five minutes later, she experienced foot drop. Therefore, she was examined immediately. Tests revealed neither effusion nor haematoma around the nerve. She underwent repeat analysis the following day, which was again negative. About 21 hours following the injection, her symptoms gradually improved, and approximately 26 hours after the injection, her symptoms completely subsided. Her motor function and gait normalised without sequelae. She was monitored over the subsequent 2 months, during which she was found to exhibit normal gait, without any deficit in the common peroneal nerve territory. Author comment: "[W]e present a woman with knee [osteoarthritis] who developed a long-lasting block with ropivacaine and common peroneal nerve palsy and foot drop following genicular block." Rahimzadeh P, et al. Common peroneal nerve palsy and long-lasting ropivacaine duration after inferolateral genicular nerve block: A case report. Interventional Pain Management Reports 3: 111-114, No. 4, Jul 2019. Available from: URL: https:// www.ipmreportsjournal.com/current/pdf?article=MzE3&journal=16 803432609 Iran

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Reactions 9 Nov 2019 No. 1778