Tsai Cheng-Jing, Wang Hsun-Mo, Lu I-Chen, Tai Chih-Feng, Wang Ling-Feng, Soo Lee-Ying, Lu David Vi
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2007 Feb;23(2):97-100. doi: 10.1016/S1607-551X(09)70383-3.
We report a young male patient who experienced seizure after local injection of 3 mL 2% lidocaine with epinephrine 1:200,000 around a recurrent nasal angiofibroma. After receiving 100% oxygen via mask and thiamylal sodium, the patient had no residual neurologic sequelae. Seizure immediately following the injection of local anesthetics in the nasal cavity is probably due to injection into venous or arterial circulation with retrograde flow to the brain circulation. Further imaging study or angiography should be done before head and neck surgeries, especially in such highly vascular neoplasm.
我们报告了一名年轻男性患者，其在复发性鼻血管纤维瘤周围局部注射3毫升含1:200,000肾上腺素的2%利多卡因后出现癫痫发作。经面罩给予100%氧气并注射硫喷妥钠后，患者未遗留神经后遗症。鼻腔局部麻醉药注射后立即发生癫痫发作可能是由于药物注入静脉或动脉循环并逆行流入脑循环所致。在头颈部手术前，尤其是在处理这种高血管性肿瘤时，应进行进一步的影像学检查或血管造影。
