Singh Georgene, Cherian Verghese T, Thomas Binu P
Department of Anaesthesiology, Christian Medical College, Vellore 632 004, Tamil Nadu, India.
J Med Case Rep. 2010 Feb 10;4:48. doi: 10.1186/1752-1947-4-48.
Purple Glove Syndrome is a devastating complication of intravenous phenytoin administration. Adequate analgesia and preservation of limb movement for physiotherapy are the two essential components of management.
A 26-year-old Tamil woman from India developed Purple Glove Syndrome after intravenous administration of phenytoin. She was managed conservatively by limb elevation, physiotherapy and oral antibiotics. A 20G intravenous cannula was inserted into the sheath of her brachial plexus and a continuous infusion of bupivacaine at a low concentration (0.1%) with fentanyl (2 mug/ml) at a rate of 1 to 2 ml/hr was given. She had adequate analgesia with preserved motor function which helped in physiotherapy and functional recovery of the hand in a month.
A continuous blockade of the brachial plexus with a low concentration of bupivacaine and fentanyl helps to alleviate the vasospasm and the pain while preserving the motor function for the patient to perform active movements of the finger and hand.
紫手套综合征是静脉注射苯妥英钠的一种严重并发症。充分镇痛和保留肢体活动以便进行物理治疗是治疗的两个关键要素。
一名来自印度的26岁泰米尔族女性在静脉注射苯妥英钠后出现了紫手套综合征。她通过抬高肢体、物理治疗和口服抗生素进行保守治疗。将一根20G静脉留置针插入她的臂丛神经鞘内，并以1至2毫升/小时的速度持续输注低浓度（0.1%）布比卡因与芬太尼（2微克/毫升）的混合液。她获得了充分的镇痛效果，同时保留了运动功能，这有助于在一个月内进行物理治疗和手部功能恢复。
用低浓度布比卡因和芬太尼持续阻滞臂丛神经有助于缓解血管痉挛和疼痛，同时保留运动功能，使患者能够对手指和手部进行主动活动。
