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SM Case Reports

A Case Report: Recurrent Aphasia after IVRA with Prilocaine in a Patient with Hand Trauma

[ ISSN : 2473-0688 ]

Abstract
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Received: 04-Aug-2017

Accepted: 28-Aug-2017

Published: 31-Aug-2017

Case Report | Volume 3 - Issue 5 | Article DOI :

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Yusuf Tunali¹, Demet Goguş², Pinar Kendigelen¹*, and Guner Kaya¹

¹Department of Anesthesiology and Intensive Care, Istanbul University, Turkey

²Clinics of Anesthesia, Florence Nightingale Hospital, Turkey

Corresponding Author:

Pinar Kendigelen, Department of Anesthesiology and IntensiveCare, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey, Tel: +905325868734; Email: pinarken@gmail.com

Keywords

Aphasia; Prilocaine; Toxicity; IVRA

Abstract

Intravenous Regional Anaesthesia (IVRA) is most commonly used for distal upper extremity operations. A patient was scheduled for the removal of a foreign body after trauma to her left hand under IVRA. A double-cuffed tourniquet applied and a dose of 15 ml 2% prilocaine was injected IV with 15ml with 0.9% NaCl via cannula. Within seconds of accidental cuff deflation, the patient developed nystagmus and aphasia and later developed seizure-like activity affecting her upperlimbs. The patient was treated with 60 mg propofol IV and ventilated with 100% oxygen. After 10 minutes she became alert and responsive to verbal commands and started speaking normally. Aphasia and difficulty in swallowing developed again after approximately 30 minutes and continued for two hours, after which symptom disappeared in less than five minutes. The serious risk of local anaesthetics systematic toxicity which may occur due to tourniquet problems or overdosage of the local anaesthetic.

Citation

Tunali Y, Gogu? D, Kendigelen P and Kaya G. A Case Report: Recurrent Aphasia after IVRA with Prilocaine in a Patient with Hand Trauma. SM J Case Rep. 2017; 3(5): 1061.