丑角综合征作为硬膜外麻醉的一种并发症。

Harlequin syndrome as a complication of epidural anesthesia.

作者信息

Boling Bryan, Key Christopher, Wainscott Justin, Rebel Annette

机构信息

Bryan Boling is a staff nurse in the cardiothoracic vascular intensive care unit and a doctoral student in the acute care nurse practitioner program at the University of Kentucky, Lexington.Christopher Key is a staff anesthesiologist, Department of Anesthesiology, University of Alabama, Birmingham.Justin Wainscott is an attending physician on the acute pain service, Department of Anesthesiology, University of Kentucky.Annette Rebel is an attending physician on the critical care service, Department of Anesthesiology, and program director of the critical care fellowship program, University of Kentucky.

出版信息

Crit Care Nurse. 2014 Jun;34(3):57-61. doi: 10.4037/ccn2014870.

DOI:10.4037/ccn2014870

PMID:24882829

Abstract

Harlequin syndrome is a rare neurological condition that results in unilateral facial flushing and sweating. Although the syndrome is generally a benign condition with complete resolution if appropriate treatment is initiated, unilateral facial flushing can be a sign of several serious conditions and should be thoroughly investigated. Sudden onset of facial flushing related to harlequin syndrome developed in a patient who had bilateral lung transplant with postoperative epidural anesthesia for pain control. Differential diagnosis includes neurovascular disease (acute stroke), malignant neoplasm of brain or lung, Horner syndrome, idiopathic hyperhidrosis, and Frey syndrome. Harlequin syndrome is often easily treated by discontinuing the anesthetic or adjusting placement of the epidural catheter.

摘要

丑角综合征是一种罕见的神经系统疾病，可导致单侧面部潮红和出汗。尽管该综合征通常为良性疾病，若开始适当治疗可完全缓解，但单侧面部潮红可能是几种严重疾病的征兆，应进行全面检查。一名接受双侧肺移植并在术后使用硬膜外麻醉控制疼痛的患者突然出现与丑角综合征相关的面部潮红。鉴别诊断包括神经血管疾病（急性中风）、脑或肺恶性肿瘤、霍纳综合征、特发性多汗症和弗雷综合征。丑角综合征通常通过停用麻醉剂或调整硬膜外导管位置即可轻松治疗。