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[在一名接受急诊剖腹手术的患者中,Sellick手法下丙泊酚诱导麻醉时发生支气管痉挛]

[Bronchospasm during crush induction with propofol under the Sellick maneuver in a patient for emergency laparotomy].

作者信息

Yamada Y, Doi K, Sato K, Yamamori Y, Saito Y

机构信息

Department of Anesthesiology, Shimane Medical University, Izumo.

出版信息

Masui. 1999 Nov;48(11):1238-40.

Abstract

A 61-year-old man was scheduled for an emergency laparotomy due to ileus. He had a history of asthma, but it was well controlled without medication. Anesthesia was induced with propofol and ketamine under the Sellick maneuver. Following administration of vecuronium, endotracheal intubation was performed. However, he could not be ventilated. We thought that the tube had been inserted into the esophagus, and re-intubation was performed. However he could not be ventilated as in the first trial. At that time, we suspected that bronchospasm had occurred. Bronchospasm improved rapidly using hyperventilation with 100% oxygen and 3-5% sevoflurane, and intravenous aminophylline. Because he had a history of asthma, propofol was relatively indicated from the point of smooth muscle relaxant effects. However we should consider the risk of bronchospasm in a patient with a history of asthma, even if we use propofol.

摘要

一名61岁男性因肠梗阻 scheduled for an emergency laparotomy。他有哮喘病史,但未用药时病情控制良好。在Sellick手法下用丙泊酚和氯胺酮诱导麻醉。给予维库溴铵后进行气管插管。然而,无法对其进行通气。我们认为导管插入了食管,于是重新插管。然而,和第一次尝试一样,仍无法对其进行通气。当时,我们怀疑发生了支气管痉挛。通过100%氧气和3 - 5%七氟醚过度通气以及静脉注射氨茶碱,支气管痉挛迅速缓解。由于他有哮喘病史,从平滑肌松弛作用的角度来看,丙泊酚相对适用。然而,即使使用丙泊酚,我们也应考虑哮喘病史患者发生支气管痉挛的风险。 (注:原文中“scheduled for an emergency laparotomy”表述不完整,推测可能是“计划进行急诊剖腹手术”之类的意思)

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