Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can induce Seizures while within Therapeutic Window: A Case Report- Abstract

What to Learn from this Article?

 1. The Reason and understanding of rare occurrence of seizures in hematoma block?

 

2. How to precaution and prevent occurrence of such seizures?


Case Report

 Volume 2 | Issue 4 | JOCR Oct-Dec 2012 | Page 10-13 Dezfuli B, Edwards CJ, DeSilva GL


Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can induce Seizures while within Therapeutic Window: A Case Report


 Authors:  Bobby Dezfuli [1], Chirstopher J Edwards  [2], Gregory L DeSilva [1]

[1] Department of Orthopaedic Surgery, University of Arizona Medical Center. Tucson, Arizona.  

[2] Department of Pharmacy, University of Arizona Medical Center. Tucson, Arizona.

Address of CorrespondenceDr. Bobby Dezfuli, MD. Department of Orthopaedic Surgery, University of Arizona Medical Center, 1609 N. Warren Avenue, Suite 110 PO Box 245064. Tucson, AZ 85724-5064 520.626.9245 (phone): 520.626.2668 (fax) Email: dezfuli@email.arizona.edu


  Abstract

  Introduction: Hematoma blocks are effective pain management modalities for closed reduction of distal radius fractures. Complications of hematoma blocks are associated with systemic reaction to anesthetic used.

 Case Report: We present a case report of an elderly patient who received a hematoma block of lidocaine and bupivacaine for a distal radius fracture and subsequently developed a generalized tonic clonic seizure. The dose of both lidocaine and bupivacaine were well within the suggested dose limit.

 Conclusion: We conclude that hematoma blocks with a combination of anesthetics may decrease the threshold to neurologic complications, especially in elderly patients. Precautions and ready teratment measures should be made available while performing closed reduction

 Keywords: Hematoma block, seizure, distal radius fracture, lidocaine, bupivacaine.


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How to Cite This Article: Dezfuli B, Edwards CJ, DeSilva GL. Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can Induce Seizures while within Therapeutic Window: a Case Report. Journal of Orthopaedic Case Reports 2012 Oct-Dec;2(4):10-13.Available from: http://www.jocr.co.in/wp/wp-content/uploads/2013/01/jocr-oct-dec-2012-5-Distal-Radius-Fracture-Hematoma-Block-with-Combined-Lidocaine-and-Bupivacaine-can-induce.pdf 

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