Bupivacaine/lidocaine

Bupivacaine/lidocaine Reactions 1704, p74 - 2 Jun 2018 Horner’s syndrome and Harlequin syndrome: case report A 31-year-old woman developed Horner’s syndrome and Harlequin syndrome following an anaesthetic bolus of bupivacaine and lidocaine. The primipara woman requested epidural analgesia during labour following induction with oxytocin at 37 weeks of gestation. She received an epidural analgesia, after which relief from labour pain was achieved. Six hours after the epidural analgesia, she was suspected for possible loss of fetal well- being during the active phase of dilatation. Therefore, an emergency caesarean was required. She received a bolus of bupivacaine 25mg and lidocaine 200mg anaesthesia through the epidural catheter with the aim of appropriate sensory- motor blocking. After fifteen minutes of epidural anaesthesia, there was an appearance of unilateral flushing on the on the right upper limb and right-hand side of the face with elevated temperature and unilateral hyperhidrosis. After a few minutes of evolution, establishment of Horner’s syndrome followed by while pallor, coldness and nausea in the left unilateral region were noted. There were no other concomitant symptoms. The women was transferred to the resuscitation unit. A differential diagnosis of Harlequin syndrome was made. In the post-surgery period, she received IV analgesic regimen and epidural catheter was removed. After eight hours of surveillance, a continuous disappearance of the ocular involvement was observed. Subsequently, unilateral flushing also disappeared. After observation, she was discharged without findings of interest at a maternal-neonatal level. Author comment: "To summarize, we reported on a case in which Harlequin and Horner’s syndromes coexisted following obstetric locoregional anaesthesia." Redondo JM, et al. Harlequin syndrome as a rare complication after epidural anaesthesia in an obstetric patient. Minerva Anestesiologica 84: 524-526, No. 4, Apr 2018. Available from: URL: http://doi.org/10.23736/S0375-9393.18.12310-8 - Spain 803323266 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Bupivacaine/lidocaine

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46717-9
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p74 - 2 Jun 2018 Horner’s syndrome and Harlequin syndrome: case report A 31-year-old woman developed Horner’s syndrome and Harlequin syndrome following an anaesthetic bolus of bupivacaine and lidocaine. The primipara woman requested epidural analgesia during labour following induction with oxytocin at 37 weeks of gestation. She received an epidural analgesia, after which relief from labour pain was achieved. Six hours after the epidural analgesia, she was suspected for possible loss of fetal well- being during the active phase of dilatation. Therefore, an emergency caesarean was required. She received a bolus of bupivacaine 25mg and lidocaine 200mg anaesthesia through the epidural catheter with the aim of appropriate sensory- motor blocking. After fifteen minutes of epidural anaesthesia, there was an appearance of unilateral flushing on the on the right upper limb and right-hand side of the face with elevated temperature and unilateral hyperhidrosis. After a few minutes of evolution, establishment of Horner’s syndrome followed by while pallor, coldness and nausea in the left unilateral region were noted. There were no other concomitant symptoms. The women was transferred to the resuscitation unit. A differential diagnosis of Harlequin syndrome was made. In the post-surgery period, she received IV analgesic regimen and epidural catheter was removed. After eight hours of surveillance, a continuous disappearance of the ocular involvement was observed. Subsequently, unilateral flushing also disappeared. After observation, she was discharged without findings of interest at a maternal-neonatal level. Author comment: "To summarize, we reported on a case in which Harlequin and Horner’s syndromes coexisted following obstetric locoregional anaesthesia." Redondo JM, et al. Harlequin syndrome as a rare complication after epidural anaesthesia in an obstetric patient. Minerva Anestesiologica 84: 524-526, No. 4, Apr 2018. Available from: URL: http://doi.org/10.23736/S0375-9393.18.12310-8 - Spain 803323266 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References

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