Accidental intravenous injection of bupivacaine: a complication of obstetrical epidural anaesthesia. Case report.

A primigravid patient in labour had an epileptiform convulsion following the first "topup" injection of bupivacaine 50 mg into the epidural space. The fit was treated successfully by artificial ventilation with oxygen and there were no subsequent ill effects in the mother. The foetus was born several hours later in good condition. The maternal venous plasma bupivacaine concentration was found to have been 2.3 yug/ml during the acute episode. An electroencephalogram performed on the patient after discharge from hospital was reported as normal.