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Case Reports
Seizure After Abdominal Surgery in an Infant Receiving a Standard-Dose Postoperative Epidural Bupivacaine Infusion.
- Peter Shapiro and Hedwig Schroeck.
- From the Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
- A A Case Rep. 2016 Apr 15; 6 (8): 238-40.
AbstractWe present the case of an otherwise healthy 12-month-old girl undergoing repair of a giant omphalocele, who experienced a postoperative seizure attributed to accumulation of bupivacaine from an epidural infusion. Whereas a standard dose was used, this patient experienced temporary liver dysfunction postoperatively, presumably from elevated intra-abdominal pressures, predisposing her to toxicity after a prolonged infusion. This case illustrates how the type of surgery can influence the margin of safety of routinely used neuraxial local anesthetic doses in infants and young children.
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