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1000 Titel
  • Two fatal and four surviving cases after accidental infusion of ropivacaine
1000 Autor/in
  1. Winkler, Michaela |
  2. Alt, Andreas |
  3. Dietzsch, Susann |
  4. Kunz, Sebastian N. |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-05-22
1000 Erschienen in
1000 Quellenangabe
  • 39(2):506-512
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s11419-021-00574-x |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:title>Abstract</jats:title><jats:sec> <jats:title>Purpose</jats:title> <jats:p>In this paper, we describe six cases, where patients were falsely treated with pre-filled ropivacaine solution instead of medical saline solution for postoperative settings. Two of the patients died because of fatal concentrations of ropivacaine in blood, four survived with no further physical injury, and two of them showed typical intoxication symptoms. The collected blood and urine samples of the deceased, as well as the surviving patients, were analyzed in laboratory routine screening.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Ropivacaine and its main metabolite 3-OH-ropivacaine were analyzed by gas chromatography–mass spectrometry.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>All of the six cases showed positive blood results of ropivacaine. Due to the poorly secured sample material of the survived patients at hospital, the quantitative examination of 3-OH-ropivacaine could not be carried out. In one fatal case, there were ropivacaine and 3-OH-ropivacaine traceable in urine. In all cases, metamizole was found in blood and traces of piritramide in urine. The amount of metamizole was within the upper limits of therapeutical treatment values. Patients with lower blood concentrations of ropivacaine showed more physical symptoms as compared to those with higher concentrations of active substances.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In the context of symptom development and intoxication, the speed of injection was a very important factor to cause fatal ropivacaine cases. To our knowledge, these are the first reported cases of fatal intoxication with ropivacaine.</jats:p> </jats:sec>
1000 Sacherschließung
lokal Malpractice
lokal Fatal poisoning
lokal GC
lokal Ropivacaine
lokal Analgesic
lokal 3-OH-ropivacaine
lokal Case Report
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0003-0132-0316|https://frl.publisso.de/adhoc/uri/QWx0LCBBbmRyZWFz|https://frl.publisso.de/adhoc/uri/RGlldHpzY2gsIFN1c2Fubg==|https://frl.publisso.de/adhoc/uri/S3VueiwgU2ViYXN0aWFuIE4u
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1000 Erstellt am 2023-04-27T13:42:30.313+0200
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