Grand mal convulsion and plasma concentrations after intravascular injection of ropivacaine for axillary brachial plexus blockade

We report a patient to whom ropivacaine 1.1 mg kg(-1) was administered for brachial plexus blockade and who developed grand mal convulsions because of inadvertent i.v. injection. No symptoms of cardiovascular toxicity occurre d. Venous blood samples were taken 15, 45, 75 and 155 min after the injecti on. The measured total plasma concentrations of ropivacaine were 3.3, 1.6, 1.2 and 1.0 mg litre(-1) respectively. Initial plasma concentration after t he end of the injection period was estimated at 5.75 mg litre(-1) using a t wo-compartment pharmacokinetic model.