Spinal Myoclonus Following Intrathecal Anesthesia with Bupivacaine for Elective Appendicectomy

Involuntary movements under anesthesia are a less recognized phenomenon. In this report, we describe a case of myoclonus in a 22 years female patient undergoing elective appendicectomy under spinal anesthesia with 0.5% hyperbaric bupivacaine. Surgery was uneventful and completed in approximately 45 min from the start of surgical incision. Myoclonic movement that appeared in the lower extremities in the early post-operative period was controlled with intravenous midazolam. Despite all biochemical and imaging tests performed, an apparent cause was not detected. After ruling out all possible causes, the diagnosis of spinal myoclonus after spinal anesthesia with bupivacaine was made by exclusion. She was fi nally discharged on 4 th post-operative day. The patient was followed up for 3 months during which she remained asymptomatic. The case warrants awareness about its occurrence, and anesthetists must watch out for and recognize it.