Sama Carlson-Babila
Galactic Corps Research Group (GCRG) and Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon.
Ethiop J Health Sci. 2016 Jul;26(4):401-4. doi: 10.4314/ejhs.v26i4.13.
Following digital surgical procedures, the ensuing post-operative course may be complicated by the presence of underlying ischaemic or vasospastic process. In the presence of such conditions, post-operative ischaemic changes may be further exacerbated with the use of local anaesthetics in combination with epinephrine.
We report a 21 year-old female who presented with an amputated fifth digit due to a rapidly spreading gangrene which started immediately after the surgical repair of a traumatic laceration which was infiltrated with a pre-mixed solution of lignocaine and epinephrine 3 hours earlier. The patient's final diagnosis was epinephrine-associated digital gangrene in the background of primary Raynaud's Phenomenon (RP).
The author reports this case in order to reiterate the importance of thorough clinical evaluation prior to the use of epinephrine in digital anaesthesia as well as to increase awareness on how primary RP can be complicated by gangrene.
在数字化外科手术后，术后过程可能因潜在的缺血或血管痉挛过程而变得复杂。在存在此类情况时，局部麻醉药与肾上腺素联合使用可能会进一步加剧术后缺血性改变。
我们报告一名21岁女性，其因迅速蔓延的坏疽导致小指截肢。坏疽在3小时前用利多卡因和肾上腺素预混溶液浸润麻醉的外伤性撕裂伤手术修复后立即开始。患者的最终诊断是原发性雷诺现象（RP）背景下的肾上腺素相关性手指坏疽。
作者报告此病例是为了重申在手指麻醉中使用肾上腺素之前进行全面临床评估的重要性，以及提高对原发性RP如何会并发坏疽的认识。
