Sardesai Anand M, Chakrabarti Anil J, Denny Nicholas M
Department of Anesthesia, Queen Eliabeth Hospital, King's Lynn, United Kingdom.
Reg Anesth Pain Med. 2004 Jan-Feb;29(1):65-8. doi: 10.1016/j.rapm.2003.08.022.
We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic infusion administered at home. This case highlights the need for patient education and postoperative communication.
report A 52-year-old male patient presented for a rotator cuff repair. He was a chronic tobacco abuser with a history of occasional chest pain of unexplained cause. An interscalene catheter was placed preoperatively and surgery was performed under a combination of an interscalene block and a general anesthetic. An infusion of 0.2% ropivacaine was started via the interscalene catheter postoperatively and continued at home following his discharge from the hospital on the third postoperative day. Within 24 hours of discharge, he was readmitted to the hospital after complaining of chest pain and dyspnea. The patient was seen in the emergency department by nonanesthesiologists who were not familiar with the potential for interscalene blocks to cause diaphragmatic paresis.
Good communication must be maintained with the patient at all times. Doctors from other specialties may be unaware of the potential complications of an interscalene block.
我们报告一例在家中进行肌间沟局部麻醉输注后发生左肺下叶肺不张的病例。该病例强调了患者教育和术后沟通的必要性。
一名52岁男性患者因肩袖修复术前来就诊。他是一名长期吸烟的人，有偶尔不明原因胸痛的病史。术前放置了肌间沟导管，手术在肌间沟阻滞和全身麻醉联合下进行。术后通过肌间沟导管开始输注0.2%罗哌卡因，并在术后第三天出院后在家中继续。出院后24小时内，他因胸痛和呼吸困难再次入院。在急诊科由不熟悉肌间沟阻滞导致膈肌麻痹可能性的非麻醉科医生对患者进行了诊治。
必须始终与患者保持良好沟通。其他专科的医生可能不知道肌间沟阻滞的潜在并发症。
