Uratsuji Y, Konishi M, Ikegaki N, Kitada H
Department of Anesthesiology, Kobe Rosai Hospital.
Masui. 1991 Jan;40(1):109-12.
A 62 year-old female developed bronchospasm after intravenous vecuronium administration. Vecuronium is reported to have major advantages over pancuronium due to the lack of significant histamine-releasing activity and cardiovascular side effects. However, macular rash, systemic collapse and bronchospasm have been reported before. The patient received cholecystectomy under general anesthesia. She had a history of urticaria when she had had a intravenous pyelography and showed positive skin test to antibiotic, ceftizoxime. During induction with thiopental plus vecuronium and on addition of vecuronium, bronchospasm was induced within five minutes in each time. Both episodes of bronchospasms were relieved with intravenous aminophylline and methylprednisolone. During the operation arterial blood gas samples were taken twice and showed no abnormal findings. Further blood samples were taken for complement C3, C4, plasma IgE and white blood cell counts. Skin test to vecuronium was also performed. In spite of these data, the mechanism of bronchospasm remained obscure. Careful attention should be paid to the use of vecuronium, especially for the patient who showed allergic response to some drugs.
一名62岁女性在静脉注射维库溴铵后发生支气管痉挛。据报道,由于维库溴铵缺乏显著的组胺释放活性和心血管副作用,与泮库溴铵相比具有主要优势。然而,之前曾有黄斑皮疹、全身性虚脱和支气管痉挛的报道。该患者在全身麻醉下接受了胆囊切除术。她有静脉肾盂造影时发生荨麻疹的病史,并且对头孢唑肟抗生素皮肤试验呈阳性。在硫喷妥钠加维库溴铵诱导麻醉期间以及追加维库溴铵时,每次均在五分钟内诱发了支气管痉挛。两次支气管痉挛发作均通过静脉注射氨茶碱和甲基强的松龙得到缓解。手术期间采集了两次动脉血气样本,结果均无异常发现。还采集了进一步的血样用于检测补体C3、C4、血浆IgE和白细胞计数。也进行了维库溴铵皮肤试验。尽管有这些数据,支气管痉挛的机制仍不清楚。使用维库溴铵时应格外小心,尤其是对于对某些药物有过敏反应的患者。