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鞘内注射巴氯芬治疗。药物泵更换期间的过量用药

[Intrathecal baclofen therapy. Overdose during replacement of a medication pump].

作者信息

Kramer K, Weber M, Koulousakis A, Lier H, Krep H

机构信息

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, Köln.

出版信息

Anaesthesist. 2009 Sep;58(9):891-6. doi: 10.1007/s00101-009-1597-x.

Abstract

This case report reviews the anesthesiological complications of intrathecal baclofen (ITB) therapy. An 11-year-old boy with spasticity and apallic syndrome needed general anesthesia for exchange of a baclofen pump but 2 h later he became increasingly hypothermic, hypotonic with bradycardy and dyspnea. The cause was an intra-operative bolus of ITB. Reduction of the baclofen administration rate caused disappearance of all symptoms without any residual effects. The ITB is an increasingly used therapeutic option for multiple sclerosis and cerebral palsy. Therefore, emergency personal and anesthesiologists must be aware of the possible side effects of this medication.

摘要

本病例报告回顾了鞘内注射巴氯芬(ITB)治疗的麻醉并发症。一名患有痉挛和去大脑强直综合征的11岁男孩在更换巴氯芬泵时需要全身麻醉,但2小时后他体温越来越低,出现低张力、心动过缓和呼吸困难。原因是术中推注了ITB。降低巴氯芬给药速率后,所有症状消失,且无任何残留影响。ITB是治疗多发性硬化症和脑瘫越来越常用的一种治疗选择。因此,急救人员和麻醉医生必须意识到这种药物可能产生的副作用。

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