序贯双侧上肢氯普鲁卡因静脉区域性麻醉。

Sequential bilateral upper extremity intravenous regional anesthesia with chloroprocaine.

机构信息

Department of Anesthesia, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.

出版信息

Can J Anaesth. 2011 Sep;58(9):842-5. doi: 10.1007/s12630-011-9545-z. Epub 2011 Jun 22.

DOI:10.1007/s12630-011-9545-z

PMID:21695564

Abstract

PURPOSE

This case report describes the novel use of sequential bilateral upper extremity intravenous regional anesthesia with 2-chloroprocaine for bilateral endoscopic carpal tunnel decompression.

CLINICAL FEATURES

A 49-yr-old female, American Society of Anesthesiologists physical status I, presented for outpatient bilateral carpal tunnel release. Sequential bilateral intravenous regional anesthesia was performed with 0.5% 2-chloroprocaine 30 mL per arm using a double upper arm tourniquet. Intraoperative sedation consisted of midazolam and fentanyl. Tourniquet times for the right and left arms were 28 and 19 min, respectively. After deflation of each tourniquet, mild limb twitching occurred but resolved immediately after administration of intravenous midazolam. The patient made a rapid recovery, and she was discharged home uneventfully.

CONCLUSIONS

Bilateral sequential intravenous regional anesthesia with 2-chloroprocaine is effective for upper extremity surgery of short duration. Recommendations to minimize the risk of local anesthetic toxicity are reviewed.

摘要

目的

本病例报告描述了使用氯普鲁卡因行序贯双侧上肢静脉区域阻滞麻醉在双侧腕管内窥镜松解术中的新应用。

临床特征

一位 49 岁的美国麻醉医师协会（ASA）身体状况 I 级女性患者，门诊行双侧腕管松解术。采用双上臂止血带，每侧上肢用 0.5%氯普鲁卡因 30mL 行序贯双侧静脉区域阻滞麻醉。术中镇静采用咪达唑仑和芬太尼。右上肢和左上肢的止血带时间分别为 28 和 19 分钟。每个止血带放气后，出现轻度肢体抽搐，但静脉注射咪达唑仑后立即缓解。患者恢复迅速，无并发症出院。