Ropivacaine: An Unusual Cause of Neuroleptic Malignant-Like Syndrome

  • Miguel Santos Serviço de Medicina Interna, Centro Hospitalar de Leiria, Leiria, Portugal
  • Sheila Arroja Serviço de Urgência Geral, Hospital de Braga, Braga, Portugal
  • Ana Luisa Antunes Serviço de Urgência Geral, Hospital de Braga, Braga, Portugal
  • Jose Mariz Serviço de Urgência Geral, Hospital de Braga, Braga, Portugal
  • Jorge Teixeira Serviço de Urgência Geral, Hospital de Braga, Braga, Portugal

Keywords

Ropivacaine, intoxication, neuroleptic malignant syndrome, secondary effects

Abstract

Ropivacaine is commonly used for post-operative pain management. We describe a case of neuroleptic malignant-like syndrome in a woman administered ropivacaine delivered using a drug infusion balloon. The presenting symptoms were confusion, agitation and fever. Blood analysis showed elevated C-reactive protein, leucocytosis and increased creatine phosphokinase. As intoxication was suspected, ropivacaine was suspended and the patient gradually improved. Possible leakage of ropivacaine into the intrathecal space may have resulted in central nervous system toxicity.

VIEW THE ENTIRE ARTICLE

References

  • Ropivacaine. Drugs.com. Available from https://www.drugs.com/monograph/ropivacaine.html
  • Kuthiala G, Chaudhary G. Ropivacaine: a review of its pharmacology and clinical use. Indian J Anaesth 2011;55(2):104–110. doi:10.4103/0019-5049.79875
  • Kimura Y, Kamada Y, Kimura A, Orimo K. Ropivacaine-induced toxicity with overdose suspected after axillary brachial plexus block. J Anesth 2007;21(3):413–416. doi: 10.1007/s00540-007-0518-x. PMID: 17680197.
  • Berman BD. Neuroleptic malignant syndrome: a review for neurohospitalists. Neurohospitalist 2011;1(1):41–47. doi:10.1177/1941875210386491
  • Published: 2021-11-08

    Issue: 2021: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    1.
    Santos M, Arroja S, Antunes AL, Mariz J, Teixeira J. Ropivacaine: An Unusual Cause of Neuroleptic Malignant-Like Syndrome. EJCRIM 2021;2 doi:10.12890/2021_002971.

    Most read articles by the same author(s)