caa a22 4500 445373482 CHVBK 20180317142955.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00540-011-1125-4 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1125-4 Successful treatment of ropivacaine-induced central nervous system toxicity by use of lipid emulsion: effect on total and unbound plasma fractions [Elektronische Daten] [Koh Mizutani, Yutaka Oda, Hajime Sato] A 24-year-old man underwent surgery for a fractured left clavicle and received an interscalene brachial plexus block for intraoperative and postoperative analgesia. After injection of 40ml 0.5% ropivacaine and confirmation of analgesia, general anesthesia was induced and maintained with propofol. Although the operation was completed uneventfully, the patient was restless and there was limb twitching during emergence from anesthesia. Ropivacaine-induced toxicity was suspected, and a dose of 100ml 20% lipid emulsion was infused intravenously. The symptoms of toxicity disappeared, and there was full recovery of consciousness within 5min. Plasma concentrations of total and protein-unbound ropivacaine measured 2h 20min after local injection were 1.99 and 0.13μg/ml, respectively. After infusion of lipid emulsion, the ropivacaine concentrations decreased to 1.72 and 0.05μg/ml, respectively. The patient had no pain, and neurological examination revealed sensory loss around the clavicle. The patient was discharged without any complications. Japanese Society of Anesthesiologists, 2011 Local anesthetic nationallicence Ropivacaine nationallicence Toxicity nationallicence Peripheral nerve block nationallicence Lipid emulsion nationallicence Mizutani Koh Department of Anesthesia and Operating Theater, Osaka Kaisei Hospital, 1-6-10, Miyahara, Yodogawa-ku, 532-0003, Osaka, Japan aut Oda Yutaka Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan aut Sato Hajime Division of Intensive Care Unit, Hyogo College of Medicine, Nishinomiya, Japan aut Journal of Anesthesia Springer Japan 25/3(2011-06-01), 442-445 0913-8668 25:3<442 2011 25 540 https://doi.org/10.1007/s00540-011-1125-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1125-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mizutani Koh Department of Anesthesia and Operating Theater, Osaka Kaisei Hospital, 1-6-10, Miyahara, Yodogawa-ku, 532-0003, Osaka, Japan aut NATIONALLICENCE 700 1- Oda Yutaka Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka, Japan aut NATIONALLICENCE 700 1- Sato Hajime Division of Intensive Care Unit, Hyogo College of Medicine, Nishinomiya, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/3(2011-06-01), 442-445 0913-8668 25:3<442 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer