Bupivacaine-induced Nicolau Syndrome during Spinal Anesthesia: A Rare Presentation of Two Cases
Published: 2023-06-14
Page: 43-47
Issue: 2023 - Volume 6 [Issue 1]
Abhishek Kumar *
Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh, India.
Shivani Varshney
Teerthanker Mahaveer College of Pharmacy, Moradabad, Uttar Pradesh, India.
Astha Lalwani Rastogi
Teerthanker Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
K. S. Dhillon
Teerthanker Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
Shubhra Aggarwal
Teerthanker Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
Yash Goel
Teerthanker Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
Prithpal Singh Matreja
Teerthanker Mahaveer Medical College and Research Center, Moradabad, Uttar Pradesh, India.
*Author to whom correspondence should be addressed.
Abstract
Purpose: We present an embolia cutis medicamentosa (Nicolau syndrome) case in a patient who received a BUPIVACANE injection with spinal anesthesia.
Summary: A pregnant woman who received a Bupivacaine injection in the OT developed a necrotic lesion at the Bupivacaine injection site on her lower back. Her chief complaints were oligohydramnios, deranged LFT, hypothyroidism, and Doppler changes. After 10 days of wound care involving topical therapy, certain medications, and frequent follow-up appointments, the patient’s wound was resolved.
Conclusion: Nicolau syndrome developed in the lower back side of a patient following a parenteral injection of BUPIVACANE. A proper injection technique is recommended to reduce the risk of this idiopathic adverse effect.
Keywords: Nicolau syndrome, livedoid dermatitis, bupivacaine injection, embolia cutis medicamentosa