Schneider H, Paul A
Abteilung für Anästhesiologie und operative Intensivmedizin am Klinikum, Aschaffenburg.
Anaesthesist. 1992 Jul;41(7):423-5.
Hypo- and hypertension, arrhythmias, bradycardia extending to cardiac arrest with circulatory failure, pneumothorax, allergic reactions with or without anaphylactic shock, production of methaemoglobin, vomiting, vertigo, disorientation, acoustic and visual disorders, tinnitus, slurred speech, muscle contractions, unconsciousness, and epileptic seizures are well-known complications associated with local anaesthetics. We have observed an additional central nervous system complication: a case of transient, total motor aphasia (Broca aphasia) in a 50-year-old patient after axillary blockade of the brachial plexus. Possible causes such as type and dosage of local anaesthetic or a transient ischaemic attack in the area of the prerolandic artery are discussed and related to the literature. Ultimately, however, it is still not apparent why this complication could appear although there was no overdosage intravascular injection, or abnormality of the pulse or blood pressure, and why its manifestation was limited to a motor aphasia.
低血压和高血压、心律失常、心动过缓甚至发展为伴有循环衰竭的心脏骤停、气胸、有无过敏性休克的过敏反应、高铁血红蛋白的产生、呕吐、眩晕、定向障碍、听觉和视觉障碍、耳鸣、言语不清、肌肉收缩、意识丧失以及癫痫发作都是与局部麻醉剂相关的众所周知的并发症。我们观察到了另外一种中枢神经系统并发症：一名50岁患者在臂丛神经腋路阻滞术后出现了一例短暂性完全运动性失语（布罗卡失语）。文中讨论了诸如局部麻醉剂的类型和剂量或额前动脉区域的短暂性缺血发作等可能原因，并与相关文献进行了关联。然而，最终仍不清楚为何尽管没有过量血管内注射、脉搏或血压异常，这种并发症仍会出现，以及为何其表现仅限于运动性失语。
