Leão Pedro, Figueiredo Paulo
Department of Anesthesiology and Pain Medicine, Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido Pinho, 4520-211 Santa Maria da Feira, Portugal.
Director of the Department of Anesthesiology and Pain Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
Patient Saf Surg. 2016 Mar 15;10:10. doi: 10.1186/s13037-016-0098-5. eCollection 2016.
Some paraplegic patients may wish undergo some surgical procedures, like urological procedures, without anesthesia. However, these patients can develop autonomic hyperreflexia if cystoscopy is performed without anesthesia.
We present a case of severe autonomic hyperreflexia in a 44-year-old male with spinal cord injury at the level of T4 during urologic procedure under sedation and analgesia successfully treated with intravenous lidocaine.
This case illustrates that patients with spinal cord injuries are likely to develop autonomic hyperreflexia during urological procedures performed without anesthesia. Health professionals should educate spinal cord injury patients regarding risks of this serious condition and be aware to prevent and manage autonomic hyperreflexia. In an acute episode, nifedipine, nitrates and captopril are the most commonly used and recommended agents. To our knowledge, this is the first case report of severe autonomic hyperreflexia treated successfully with intravenous lidocaine.
一些截瘫患者可能希望在无麻醉的情况下接受某些外科手术，如泌尿外科手术。然而，如果在无麻醉的情况下进行膀胱镜检查，这些患者可能会发生自主神经反射亢进。
我们报告一例44岁男性在镇静镇痛下进行泌尿外科手术时发生严重自主神经反射亢进的病例，该男性在T4水平脊髓损伤，经静脉注射利多卡因成功治疗。
该病例表明，脊髓损伤患者在无麻醉的泌尿外科手术过程中可能会发生自主神经反射亢进。卫生专业人员应向脊髓损伤患者宣传这种严重情况的风险，并注意预防和处理自主神经反射亢进。在急性发作时，硝苯地平、硝酸盐和卡托普利是最常用和推荐的药物。据我们所知，这是首例静脉注射利多卡因成功治疗严重自主神经反射亢进的病例报告。
