Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block
OBJECTIVELocal anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB). CASE REPORTThree patients underwent total knee arthroplasty that was...
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| Veröffentlicht in: | Regional anesthesia and pain medicine 2016-11, Vol.41 (6), p.723-727 |
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| creator | Neal, Joseph M Salinas, Francis V Choi, Daniel S |
| description | OBJECTIVELocal anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB).
CASE REPORTThree patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 0.2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles. Clinical course, imaging, and neurophysiologic studies were consistent with myositis. The patients experienced partial to full functional recovery over the ensuing weeks to months.
CONCLUSIONSClinically apparent local anesthetic-induced myotoxicity has been documented rarely in humans undergoing non-ophthalmic surgery. We report 3 sentinel cases associated with continuous ACB. |
| doi_str_mv | 10.1097/AAP.0000000000000466 |
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CASE REPORTThree patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 0.2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles. Clinical course, imaging, and neurophysiologic studies were consistent with myositis. The patients experienced partial to full functional recovery over the ensuing weeks to months.
CONCLUSIONSClinically apparent local anesthetic-induced myotoxicity has been documented rarely in humans undergoing non-ophthalmic surgery. We report 3 sentinel cases associated with continuous ACB.</description><identifier>ISSN: 1098-7339</identifier><identifier>EISSN: 1532-8651</identifier><identifier>DOI: 10.1097/AAP.0000000000000466</identifier><identifier>PMID: 27662067</identifier><language>eng</language><publisher>England: Copyright by American Society of Regional Anesthesia and Pain Medicine</publisher><subject>Aged ; Amides - administration & dosage ; Amides - adverse effects ; Anesthetics, Local - administration & dosage ; Anesthetics, Local - adverse effects ; Arthroplasty, Replacement, Knee - adverse effects ; Case reports ; Female ; Humans ; Lidocaine - administration & dosage ; Lidocaine - adverse effects ; Local anesthesia ; Magnetic Resonance Imaging ; Male ; Mepivacaine - administration & dosage ; Mepivacaine - adverse effects ; Middle Aged ; Muscle Strength - drug effects ; Muscle Weakness - chemically induced ; Muscle Weakness - physiopathology ; Myositis - chemically induced ; Myositis - diagnosis ; Myositis - physiopathology ; Nerve Block - adverse effects ; Pain, Postoperative - diagnosis ; Pain, Postoperative - etiology ; Pain, Postoperative - prevention & control ; Quadriceps Muscle - drug effects ; Quadriceps Muscle - physiopathology ; Recovery of Function ; Regional anesthesia ; Ropivacaine ; Time Factors ; Treatment Outcome</subject><ispartof>Regional anesthesia and pain medicine, 2016-11, Vol.41 (6), p.723-727</ispartof><rights>Copyright © 2016 by American Society of Regional Anesthesia and Pain Medicine.</rights><rights>Copyright © 2016 by American Society of Regional Anesthesia and Pain Medicine2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4506-a78a9f44187f1f8e9b61c29df91184d669080747fb40094248baad5ea5b490093</citedby><cites>FETCH-LOGICAL-c4506-a78a9f44187f1f8e9b61c29df91184d669080747fb40094248baad5ea5b490093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27662067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neal, Joseph M</creatorcontrib><creatorcontrib>Salinas, Francis V</creatorcontrib><creatorcontrib>Choi, Daniel S</creatorcontrib><title>Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block</title><title>Regional anesthesia and pain medicine</title><addtitle>Reg Anesth Pain Med</addtitle><description>OBJECTIVELocal anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB).
CASE REPORTThree patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 0.2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles. Clinical course, imaging, and neurophysiologic studies were consistent with myositis. The patients experienced partial to full functional recovery over the ensuing weeks to months.
CONCLUSIONSClinically apparent local anesthetic-induced myotoxicity has been documented rarely in humans undergoing non-ophthalmic surgery. We report 3 sentinel cases associated with continuous ACB.</description><subject>Aged</subject><subject>Amides - administration & dosage</subject><subject>Amides - adverse effects</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Anesthetics, Local - adverse effects</subject><subject>Arthroplasty, Replacement, Knee - adverse effects</subject><subject>Case reports</subject><subject>Female</subject><subject>Humans</subject><subject>Lidocaine - administration & dosage</subject><subject>Lidocaine - adverse effects</subject><subject>Local anesthesia</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Mepivacaine - administration & dosage</subject><subject>Mepivacaine - adverse effects</subject><subject>Middle Aged</subject><subject>Muscle Strength - drug effects</subject><subject>Muscle Weakness - chemically induced</subject><subject>Muscle Weakness - physiopathology</subject><subject>Myositis - chemically induced</subject><subject>Myositis - diagnosis</subject><subject>Myositis - physiopathology</subject><subject>Nerve Block - adverse effects</subject><subject>Pain, Postoperative - diagnosis</subject><subject>Pain, Postoperative - etiology</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Quadriceps Muscle - drug effects</subject><subject>Quadriceps Muscle - physiopathology</subject><subject>Recovery of Function</subject><subject>Regional anesthesia</subject><subject>Ropivacaine</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1098-7339</issn><issn>1532-8651</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kMtOwzAURC0EolD4A4QisWGTYjt-LkPFo6gIFrC2HMdR07oxxIlK_x5XLQh1wd346urMeDQAXCA4QlDymzx_HcG_Qxg7ACeIZjgVjKLDuEMpUp5lcgBOQ5hHRnDCjsEAc8YwZPwEPE290S7JGxu6me1qk06asje2TJ7XvvNftam7dZJXnW2TsW-6uul9H5K8jFDn4003UX7rvFmcgaNKu2DPd-8QvN_fvY0f0-nLw2ScT1NDKGSp5kLLihAkeIUqYWXBkMGyrCRCgpSMSSggJ7wqCISSYCIKrUtqNS2IjJdsCK63vh-t_-xjbrWsg7HO6cbGbAqJjFKMBcURvdpD575vY-KgMKUZ2nywMSRbyrQ-hNZW6qOtl7pdKwTVpmsVu1b7XUfZ5c68L5a2_BX9lBsBsQVW3sX-wsL1K9uqmdWum_3v_Q1AuIhh</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Neal, Joseph M</creator><creator>Salinas, Francis V</creator><creator>Choi, Daniel S</creator><general>Copyright by American Society of Regional Anesthesia and Pain Medicine</general><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201611</creationdate><title>Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block</title><author>Neal, Joseph M ; Salinas, Francis V ; Choi, Daniel S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4506-a78a9f44187f1f8e9b61c29df91184d669080747fb40094248baad5ea5b490093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Amides - administration & dosage</topic><topic>Amides - adverse effects</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Anesthetics, Local - adverse effects</topic><topic>Arthroplasty, Replacement, Knee - adverse effects</topic><topic>Case reports</topic><topic>Female</topic><topic>Humans</topic><topic>Lidocaine - administration & dosage</topic><topic>Lidocaine - adverse effects</topic><topic>Local anesthesia</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Mepivacaine - administration & dosage</topic><topic>Mepivacaine - adverse effects</topic><topic>Middle Aged</topic><topic>Muscle Strength - drug effects</topic><topic>Muscle Weakness - chemically induced</topic><topic>Muscle Weakness - physiopathology</topic><topic>Myositis - chemically induced</topic><topic>Myositis - diagnosis</topic><topic>Myositis - physiopathology</topic><topic>Nerve Block - adverse effects</topic><topic>Pain, Postoperative - diagnosis</topic><topic>Pain, Postoperative - etiology</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Quadriceps Muscle - drug effects</topic><topic>Quadriceps Muscle - physiopathology</topic><topic>Recovery of Function</topic><topic>Regional anesthesia</topic><topic>Ropivacaine</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neal, Joseph M</creatorcontrib><creatorcontrib>Salinas, Francis V</creatorcontrib><creatorcontrib>Choi, Daniel S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Regional anesthesia and pain medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neal, Joseph M</au><au>Salinas, Francis V</au><au>Choi, Daniel S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block</atitle><jtitle>Regional anesthesia and pain medicine</jtitle><addtitle>Reg Anesth Pain Med</addtitle><date>2016-11</date><risdate>2016</risdate><volume>41</volume><issue>6</issue><spage>723</spage><epage>727</epage><pages>723-727</pages><issn>1098-7339</issn><eissn>1532-8651</eissn><abstract>OBJECTIVELocal anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB).
CASE REPORTThree patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 0.2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles. Clinical course, imaging, and neurophysiologic studies were consistent with myositis. The patients experienced partial to full functional recovery over the ensuing weeks to months.
CONCLUSIONSClinically apparent local anesthetic-induced myotoxicity has been documented rarely in humans undergoing non-ophthalmic surgery. We report 3 sentinel cases associated with continuous ACB.</abstract><cop>England</cop><pub>Copyright by American Society of Regional Anesthesia and Pain Medicine</pub><pmid>27662067</pmid><doi>10.1097/AAP.0000000000000466</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Amides - administration & dosage Amides - adverse effects Anesthetics, Local - administration & dosage Anesthetics, Local - adverse effects Arthroplasty, Replacement, Knee - adverse effects Case reports Female Humans Lidocaine - administration & dosage Lidocaine - adverse effects Local anesthesia Magnetic Resonance Imaging Male Mepivacaine - administration & dosage Mepivacaine - adverse effects Middle Aged Muscle Strength - drug effects Muscle Weakness - chemically induced Muscle Weakness - physiopathology Myositis - chemically induced Myositis - diagnosis Myositis - physiopathology Nerve Block - adverse effects Pain, Postoperative - diagnosis Pain, Postoperative - etiology Pain, Postoperative - prevention & control Quadriceps Muscle - drug effects Quadriceps Muscle - physiopathology Recovery of Function Regional anesthesia Ropivacaine Time Factors Treatment Outcome |
| title | Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block |
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