Distal Radius Fracture Hematoma Block with Combined Lidocaine and Bupivacaine can induce Seizures while within Therapeutic Window: A Case Report

Hematoma blocks are effective pain management modalities for closed reduction of distal radius fractures. Complications of hematoma blocks are associated with systemic reaction to anesthetic used. We present a case report of an elderly patient who received a hematoma block of lidocaine and bupivacai...

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Bibliographic Details
Published inJournal of orthopaedic case reports Vol. 2; no. 4; pp. 10 - 13
Main Authors Dezfuli, Bobby, Edwards, Christopher J, DeSilva, Gregory L
Format Journal Article
LanguageEnglish
Published India Indian Orthopaedic Research Group 01.10.2012
Subjects
Case Report
seizure
bupivacaine
Hematoma block
lidocaine
distal radius fracture
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Summary:Hematoma blocks are effective pain management modalities for closed reduction of distal radius fractures. Complications of hematoma blocks are associated with systemic reaction to anesthetic used. We present a case report of an elderly patient who received a hematoma block of lidocaine and bupivacaine for a distal radius fracture and subsequently developed a generalized tonic clonic seizure. The dose of both lidocaine and bupivacaine were well within the suggested dose limit. The episode was self limiting and patient had the cast applied. We conclude that hematoma blocks with a combination of anesthetics may decrease the threshold to neurologic complications, especially in elderly patients. Precautions and ready treatment measures should be made available while performing closed reduction.
ISSN:2250-0685
2321-3817