Possible Bupivacaine Induced Hepatitis Following Wide Awake, Local Anesthesia, No Tourniquet Carpal Tunnel Surgery: A Case Report

J Hand Surg Glob Online. 2024 Sep 14;6(6):931-933. doi: 10.1016/j.jhsg.2024.08.010. eCollection 2024 Nov.

Abstract

In this case report, we present a novel occurrence of acute hepatitis 2 weeks after local bupivacaine injection for wide awake, local anesthesia, no tourniquet carpal tunnel release. Laboratory and biopsy analysis confirmed cholestatic, drug-induced hepatitis that was successfully managed with conservative treatment. With a paucity of potential bupivacaine-induced hepatitis cases reported within the literature, the importance of broad differential diagnosis, meticulous medication reconciliation, and consideration of this rare complication should not be understated by the astute hand surgeon.

Keywords: Acute hepatitis; Bupivacaine; Carpal tunnel syndrome; Complications; Local anesthesia; WALANT.

Publication types

  • Case Reports