Cheung Man-Yiu, Viney Melissa
Geelong Hospital, Victoria, Australia.
Anesth Analg. 2007 Oct;105(4):1127-9, table of contents. doi: 10.1213/01.ane.0000280536.96489.95.
Postherpetic neuralgia is considered to be the most common and debilitating complication of acute herpes zoster and its incidence and duration of symptoms increase with age. We describe an unusual, but life-threatening complication of postherpetic neuralgia. The following case report is the first to describe a patient who developed unexpected asystolic episodes as a result of complicating pain secondary to acute herpetic ophthalmicus. The underlying pathogenesis of her cardiovascular disturbance coinciding with her painful paroxysms is unclear. This uncommon phenomenon may be explained by an exaggerated vasovagal response or even by the oculocardiac reflex rarely observed outside ocular or maxillofacial surgery. Her severe paroxysmal pain and asystole were eventually managed with oxycontin, amitriptyline, gabapentin, and intranasal fentanyl spray.
带状疱疹后神经痛被认为是急性带状疱疹最常见且使人衰弱的并发症，其发病率及症状持续时间会随着年龄增长而增加。我们描述了一种不常见但危及生命的带状疱疹后神经痛并发症。以下病例报告首次描述了一名患者，该患者因急性疱疹性眼炎继发的疼痛并发症而出现意外的心搏停止发作。其心血管紊乱与疼痛性发作同时出现的潜在发病机制尚不清楚。这种罕见现象可能是由过度的血管迷走神经反应所解释，甚至可能是由在眼科或颌面外科手术之外很少观察到的眼心反射所导致。她严重的阵发性疼痛和心搏停止最终通过奥施康定、阿米替林、加巴喷丁和鼻内芬太尼喷雾剂得到控制。
