摘要
本文报道1例由分娩镇痛转剖宫产术中局麻药中毒的病例,患者从开始实施分娩镇痛至转剖宫产入室前,镇痛效果良好,视觉模拟评分法评分0~2分。入室后回抽硬膜外导管内无血液及脑脊液回流,2%盐酸利多卡因3 ml注入硬膜外腔,5 min后患者未诉不适,追加1%盐酸罗哌卡因10 ml,10 min后开始手术。取出胎儿、胎盘后进一步探查时,患者疼痛感明显,麻醉医生再次追加1%盐酸罗哌卡因5 ml,追加药物5 min后,患者出现抽搐、耳鸣。分析原因为硬膜外分娩镇痛期间及转硬膜外麻醉后手术期间,均存在硬膜外导管移位并进入血管的可能,故每次注药前均应常规回抽。
This article reported a case of local anesthetic poisoning during the transition from labor analgesia to cesarean section.The patient had a good analgesic effect from the beginning of labor analgesia to the transition to cesarean section before entering the operating room,and the visual analogue scale score was 0-2 points.After entering the room,there was no blood and cerebrospinal fluid reflux in the epidural catheter.3 ml of 2%Lidocaine Hydrochloride was injected into the epidural space.After 5 minutes,the patient did not complain of discomfort.10 ml of 1%Ropivacaine Hydrochloride was added.The operation started 10 minutes later.When the fetus and placenta were taken out for further exploration,the patient felt obvious pain.The anesthesiologist added another 5 ml of 1%Ropivacaine Hydrochloride.Five minutes after adding the drug,the patient had convulsions and tinnitus.The reason is that there is a possibility of the epidural catheter shifting and entering the blood vessels during epidural labor analgesia and during the operation after epidural anesthesia.So routine withdrawal should be performed before each injection.
作者
刘绪才
万兵
LIU Xucai;WAN Bing(Department of Anesthesiology,Chongqing Jiangjin District Maternal and Child Health Hospital,Chongqing 402260,China)
出处
《妇儿健康导刊》
2023年第2期105-107,共3页
JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE
关键词
分娩镇痛
剖宫产
局麻药中毒
Labor analgesia
Cesarean section
Local anesthetic poisoning
