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葡萄糖-6-磷酸脱氢酶(G6PD)缺乏的老年创伤患者的超声引导区域麻醉

Ultrasound-Guided Regional Anesthesia in a Glucose-6-Phosphate Dehydrogenase (G6PD)-Deficient Geriatric Trauma Patient.

作者信息

Födinger Agnes M, Kammerlander Christian, Luger Thomas J

机构信息

Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Austria.

出版信息

Geriatr Orthop Surg Rehabil. 2012 Dec;3(4):147-9. doi: 10.1177/2151458512472903.

Abstract

OBJECTIVE

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic enzymatic disorder causing hemolytic anemia. Exposure to drugs is considered to be the most common cause of acute hemolysis in patients with G6PD deficiency. Experience with regional anesthesia, in particular peripheral nerve blocks, is rarely described in patients with G6PD deficiency, but is of great clinical interest. For this reason, we now report on the successful management of ultrasound-guided axillary brachial plexus block in a patient with geriatric G6PD deficiency.

CASE REPORT

A female, 75-year-old geriatric trauma patient with G6PD deficiency and a fracture of the left forearm, was scheduled for osteosynthesis of the left forearm. For surgery regional anesthesia with ultrasound-guided axillary brachial plexus block with 30 mL bupivacaine 0.5% was established. Surgical operation und postoperative course were uneventful and with no signs of hemolysis.

CONCLUSION

Ultrasound-guided axillary brachial plexus block with bupivacaine was a safe and effective technique in this patient with G6PD deficiency. Peripheral nerve block is a major analgesic approach and of great value for anesthesiologists and surgeons, especially in our aging and multimorbid society.

摘要

目的

葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症是一种导致溶血性贫血的遗传性酶病。接触药物被认为是G6PD缺乏症患者急性溶血的最常见原因。G6PD缺乏症患者很少有区域麻醉的经验,尤其是周围神经阻滞,但这具有很大的临床意义。因此,我们现在报告一例老年G6PD缺乏症患者超声引导下腋路臂丛神经阻滞的成功管理。

病例报告

一名75岁的老年女性创伤患者,患有G6PD缺乏症和左前臂骨折,计划进行左前臂骨固定术。手术采用超声引导下腋路臂丛神经阻滞,使用30毫升0.5%布比卡因进行区域麻醉。手术过程和术后恢复顺利,无溶血迹象。

结论

在该G6PD缺乏症患者中,超声引导下使用布比卡因进行腋路臂丛神经阻滞是一种安全有效的技术。周围神经阻滞是一种主要的镇痛方法,对麻醉医生和外科医生具有重要价值,尤其是在我们这个老龄化和多病共存的社会中。

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