Gooch Ingrid, Gwinnutt Carl
Department of Anaesthesia, Hope Hospital, Stott Lane, Salford M6 8HD, UK.
Resuscitation. 2006 Sep;70(3):470-3. doi: 10.1016/j.resuscitation.2006.02.004. Epub 2006 Aug 9.
A 42-year-old male underwent a total hip arthroplasty under subarachnoid anaesthesia with intrathecal bupivacaine and diamorphine. Shortly after the start of surgery, he suffered an allergic reaction that, at first, was difficult to distinguish from the recognised side-effects of intrathecal diamorphine. Once the diagnosis was made, he was treated with adrenaline and made a full recovery. The serum concentration of mast cell tryptase approximately 1.5h after the onset of the adverse incident confirmed an anaphylactic reaction. Skin prick testing several weeks later identified diamorphine as the likely causative agent, a drug overlooked initially as a potential cause. We believe this is the first report of intrathecal diamorphine causing anaphylaxis.
一名42岁男性在蛛网膜下腔麻醉下接受了全髋关节置换术，术中使用了鞘内布比卡因和二醋吗啡。手术开始后不久，他出现了过敏反应，起初难以与鞘内注射二醋吗啡已知的副作用区分开来。一旦确诊，他接受了肾上腺素治疗并完全康复。不良事件发生后约1.5小时测得的肥大细胞类胰蛋白酶血清浓度证实了过敏反应。几周后进行的皮肤点刺试验确定二醋吗啡可能是致病因素，这种药物最初被忽视了其作为潜在病因的可能性。我们认为这是鞘内注射二醋吗啡引起过敏反应的首例报告。
