Complicações da administração intratecal acidental de bupivacaína em modelo experimental ovino
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Data
2015-06
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Resumo
Lumbar epidural anesthesia is widely used in sheep due to several advantages over
general anesthesia. The usage of bupivacaine in this technique has grown due to its
long anesthetic effect and the possibility of postoperative analgesia. However,
racemic bupivacaine is a highly toxic drug whose accidental administration can lead
to serious complications. The present study aimed at reporting complications in two
sheep undergoing experimental surgery after intrathecal administration of
bupivacaine, via epidural catheter accidentally positioned. Epidural space was
accessed by the lumbosacral region with a 17-gauge Tuohy needle and confirmed by
the absence of resistance to injection and negative suction of cerebrospinal fluid
(CSF). Subsequently, a 16-gauge epidural catheter was introduced up to the second
and forth lumbar vertebrae. The animals were sedated with 0.05mg/kg of xylazine
and 0.1mg/kg of morphine given intramuscularly, twenty-four hours after catheter
placement. A further confirmation of the absence of CSF was performed and, after
negative suction, 1mg/kg of bupivacaine 0.5% was administered. Between four and
nine minutes after intrathecal administration, the animals showed respiratory distress
followed by cardiac arrest without success to cardiopulmonary resuscitation
procedures. The incorrect positioning of the catheters was revealed only at necropsy.
Thus, this report highlights the risk of accidental deployment of epidural catheters
into the subarachnoid space and features the importance of imaging methods to
confirm the correct positioning.
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Palavras-chave
Anestésicos locais, Espaço subaracnoideo, Intoxicação, Ovelhas, Local anesthetic, Subarachnoid space, Intoxication, Sheep
Citação
VILLELA, Ana Carolina Vasques; SILVA, Luiz Henrique da; BITTAR, Isabella Plazza; BORGES, Naida Cristina; FRANCO, Leandro Guimarães. Complicações da administração intratecal acidental de bupivacaína em modelo experimental ovino. Enciclopédia Biosfera, Goiânia, v. 11, n. 21, p. 593, jun. 2015.