Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos

Fábio Geraldo Curtis; Robson Furlani; Yara Marcondes Machado Castiglia

doi:10.1590/S0034-70942004000600009

Clinical Information

Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos

Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports

Fábio Geraldo Curtis; Robson Furlani; Yara Marcondes Machado Castiglia

http://dx.doi.org/10.1590/S0034-70942004000600009 Braz J Anesthesiol, vol.54, n6, p.802-808, 2004

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Resumo

JUSTIFICATIVA E OBJETIVOS: A ropivacaína foi introduzida na prática clínica há pouco mais de dez anos, associando-se a baixo risco de complicações do sistema nervoso central e cardiovascular. O objetivo destes relatos é apresentar um caso de parada cardíaca e outro de toxicidade neurológica, após injeção intravascular acidental da ropivacaína, durante a realização de anestesias peridurais. RELATO DOS CASOS: Trata-se de duas pacientes submetidas a cirurgias plásticas estéticas sob anestesia peridural torácica com ropivacaína a 0,5%. Durante a realização da técnica, uma delas apresentou parada cardíaca em assistolia e a outra, toxicidade neurológica. Prontamente atendidas, ambas apresentaram rápida recuperação, tendo sido possível a realização dos respectivos atos cirúrgicos. CONCLUSÕES: O reconhecimento e o tratamento rápidos da injeção intravascular acidental, bem como as características farmacológicas da ropivacaína foram decisivos, em ambos os casos, na boa recuperação das pacientes.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, COMPLICAÇÕES, TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: Ropivacaine was introduced in the clinical practice a little more than 10 years ago, and has been associated to low risk for central nervous system and cardiovascular complications. These reports aimed at presenting a case of cardiac arrest and another one of neurological toxicity after accidental intravascular ropivacaine injection during epidural anesthesia. CASE REPORTS: Two patients undergoing cosmetic plastic surgeries were submitted to thoracic epidural anesthesia with 0.5% ropivacaine. After anesthetic injection, one has presented cardiac arrest in asystole and the other had signs of neurological toxicity. Patients were promptly treated and presented fast recovery, in a way that both surgical procedures could be performed. CONCLUSIONS: The prompt Identification and treatment of the accidental intravascular injection, as well as ropivacaine pharmacological profile, were decisive in both cases for the satisfactory recovery of our patients.

Keywords

ANESTHETICS, ANESTHETICS, ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES, COMPLICATIONS

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Injeção intravascular acidental de ropivacaína a 0,5% durante a realização de anestesia peridural torácica: relato de casos

Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports

Fábio Geraldo Curtis; Robson Furlani; Yara Marcondes Machado Castiglia

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