Galante D
Department of Anesthesia and Intensive Care, Ospedali Riuniti University Hospital, Foggia, Italy.
Minerva Anestesiol. 2009 Apr;75(4):221-3. Epub 2008 Dec 17.
A 73-year-old, ASA I patient scheduled for transurethral resection of the prostate under subarachnoid anesthesia received, prior to the beginning of the surgery, intravenous imipenem/cilastatin 1 g for a urinary infection with multiresistant Escherichia coli. The patient developed seizures during the surgical procedure. Central nervous toxicity of imipenem/cilastatin might have been the cause of the seizures. After appropriate management, the patient recovered well and was discharged without complications. The differential diagnosis between systemic toxicity of local anesthetics and imipenem-related seizures is discussed.
一名73岁、美国麻醉医师协会（ASA）分级为I级的患者计划在蛛网膜下腔麻醉下行经尿道前列腺切除术。手术开始前，因多重耐药的大肠埃希菌引起的泌尿系统感染，给予患者静脉注射1g亚胺培南/西司他丁。患者在手术过程中出现癫痫发作。亚胺培南/西司他丁的中枢神经毒性可能是癫痫发作的原因。经过适当处理，患者恢复良好，无并发症出院。本文讨论了局部麻醉药全身毒性与亚胺培南相关癫痫发作的鉴别诊断。
