University of Iowa, Iowa City, IA.
J Clin Anesth. 2015 Aug;27(5):423-5. doi: 10.1016/j.jclinane.2015.03.037. Epub 2015 Apr 29.
A 77-year-old female with normal pressure hydrocephalus underwent urgent revision of the abdominal component of a ventriculoperitoneal shunt. Upon emergence from an uneventful general anesthetic, the patient exhibited cogwheel rigidity with decerebrate posturing and a markedly irregular respiratory rate. This prohibited extubation and prompted an unplanned intensive care unit admission. Ondansetron was the only medication administered that had previously been associated with dystonic reactions. In a previous procedure, the patient had been given ondansetron without a similar reaction. This presentation may have been provoked by existing pathology such as her underlying normal pressure hydrocephalus and small increases in intracranial pressure.
一位 77 岁女性因正常压力脑积水接受了紧急的脑室腹膜分流术腹部组件的翻修。在全身麻醉下安然苏醒后，患者出现齿轮样僵硬伴去脑强直和明显不规则的呼吸频率。这妨碍了拔管，并促使计划外入住重症监护病房。昂丹司琼是唯一一种先前与张力障碍反应相关的药物。在之前的手术中，患者曾使用过昂丹司琼，但没有出现类似的反应。这种表现可能是由她潜在的正常压力脑积水和颅内压小幅度增加等现有病理引起的。
