Generalized tonic-clonic seizure following spinal anesthesia for Cesarean section with bupivacaine: A case report

Kim, Hye Jin; Kwon, Mi Young; Kang, Hye Joo; Koo, Min Seok; Park, Jong Cook; Lee, Myung Ae

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2011;6(4):393-396.
Published online October 31, 2011.

Generalized tonic-clonic seizure following spinal anesthesia for Cesarean section with bupivacaine: A case report

Hye Jin Kim, Mi Young Kwon, Hye Joo Kang, Min Seok Koo, Jong Cook Park, Myung Ae Lee

¹Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea.
²Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea. danke1104@naver.com

Abstract

Regional anesthesia for Cesarean section is a popular anesthetic method and a subarachnoid injection of local anesthetics provides rapid onset and a reliable block. Furthermore, it maintains airway reflexes and consciousness of the parturient and is associated with less neonatal depression. Complications related with spinal anesthesia are most often postdural puncture headache, back pain, hematoma, abscess, paresthesia or motor weakness and very rarely, myoclonus. Generalized seizures as a complication following epidural anesthesia with bupivacaine has been reported, but rarely following spinal anesthesia. We present a case of a parturient who was well antenatally, but presented with generalized tonic-clonic seizures following delivery. Although the possible etiologic factors of these transient seizures after spinal anesthesia are difficult to clarify, we emphasize that careful airway monitoring after regional anesthesia is important.

Key Words: Bupivacaine, Generalized tonic-clonic seizure, Spinal anesthesia