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Revista Brasileira de Anestesiologia

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CURTIS, Fábio Geraldo; FURLANI, Robson  and  CASTIGLIA, Yara Marcondes Machado. Accidental intravascular injection of 0.5% ropivacaine during thoracic epidural anesthesia: case reports. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.6, pp.802-808. ISSN 0034-7094.

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 [Local]; ANESTHETICS [ropivacaine]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [epidural]; COMPLICATIONS [accidental injection].

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