Mallick Suchismita, Chatterjee Anirban, Basunia Sandip Roy, Bisui Bikash
Department of Anaesthesiology, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Anesth Essays Res. 2013 Jan-Apr;7(1):123-6. doi: 10.4103/0259-1162.114018.
A 17-year-old girl was posted for spinal surgery for traumatic spinal injury. The patient was a well-controlled epileptic with history of seizure since 8 years of her age. She was induced with thiopentone sodium and muscle relaxant atracurium was administered. Minutes after that, she had an episode of ventricular tachycardia, this converted to ventricular fibrillation despite of institution of cardiopulmonary resuscitation (CPR). CPR was continued for a prolonged period of 45 minutes and after 45 minutes, QRS complexes appeared and later sinus rhythm restored. Next 24 hours, she was kept on mechanical ventilation. Within 24 hours, Glasgow Coma Scale (GCS) improved and patient was conscious and extubated. We suggest that the neuromuscular blocking drug contributed to an anaphylactic reaction which might be the cause of cardiac arrest and highlight the importance of prolonged resuscitation and successful outcome in this scenario.
一名17岁女孩因外伤性脊柱损伤接受脊柱手术。该患者自8岁起患有癫痫,病情一直得到良好控制。她接受硫喷妥钠诱导麻醉,并给予肌肉松弛剂阿曲库铵。几分钟后,她出现室性心动过速,尽管进行了心肺复苏(CPR),仍转变为心室颤动。持续进行了长达45分钟的心肺复苏,45分钟后,出现QRS波群,随后恢复窦性心律。接下来的24小时,她一直接受机械通气。24小时内,格拉斯哥昏迷量表(GCS)评分改善,患者意识清醒并拔除气管插管。我们认为神经肌肉阻滞药物引发了过敏反应,这可能是心脏骤停的原因,并强调了在这种情况下延长复苏时间及取得成功结果的重要性。