European Journal of Case Reports in Internal Medicine (Nov 2021)

Ropivacaine: An Unusual Cause of Neuroleptic Malignant-Like Syndrome

  • Miguel Santos,
  • Sheila Arroja,
  • Ana Luisa Antunes,
  • Jose Mariz,
  • Jorge Teixeira

DOI
https://doi.org/10.12890/2021_002971

Abstract

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Ropivacaine is commonly used for post-operative pain management. We describe a case of neuroleptic malignant-like syndrome in a woman administered ropivacaine delivered using a drug infusion balloon. The presenting symptoms were confusion, agitation and fever. Blood analysis showed elevated C-reactive protein, leucocytosis and increased creatine phosphokinase. As intoxication was suspected, ropivacaine was suspended and the patient gradually improved. Possible leakage of ropivacaine into the intrathecal space may have resulted in central nervous system toxicity.

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