A FATAL CASE OF BUPIVACAINE INDUCED CENTRAL NERVOUS SYSTEM TOXICITY PRESENTING AS SUPER REFRACTORY STATUS EPILEPTICUS : A CASE REPORT

Use of local anaesthetic agent for spinal anaesthesia is routinely done for various surgical procedures . While most of the cases are done without any major adverse event , Local Anaesthetic Systemic Toxicity (LAST) can occur despite giving low dose at appropriate site .We present a case report of16 years old boy who underwent spinal anaesthesia for brodies abscess following which he developed central nervous system toxicity manifesting as super refractory status epilepticus. His course in intensive care unit got complicated with hyperthermia , rhabdomyolysis , Acute kidney injury (AKI) and Acute Respiratory Distress Syndrome(ARDS). Despite all the efforts patient couldn’t be saved and expired on day five of intensive care unit admission. Thus , one needs to be vigilant of the unpredictable and underestimated nature of bupivacaine induced central nervous system toxicity.