最初被认为是意外支气管内插管的严重呼吸事件：使用8%利多卡因定量喷雾的局部用药可能引发的并发症

Severe Respiratory Event Initially Thought to be Inadvertent Endobronchial Intubation: Possible Complications From Using of a Topical Metered-Dose of 8% Lidocaine Pump Spray.

作者信息

Arai Young-Chang P, Kawanishi Jun, Sakakima Yoshikazu, Ohmoto Koichi, Ito Akihiro, Maruyama Yuki, Ikemoto Tatsunori

机构信息

Department of Surgery, Toki General Hospital, Gifu, Japan.

Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, Aichi, Japan.

出版信息

Anesth Pain Med. 2016 Apr 16;6(3):e33771. doi: 10.5812/aapm.33771. eCollection 2016 Jun.

DOI:10.5812/aapm.33771

PMID:27642575

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5018134/

Abstract

INTRODUCTION

Pulmonary collapse after intubation is common, and it is caused by a variety of factors.

CASE PRESENTATION

A 21-year-old man presented at our operation room to undergo an appendectomy. Except for a history of cigarette smoking, his history was negative. Anesthesia was induced with 100% oxygen and sevoflurane, remifentanil infusion, and propofol. Neuromuscular block was obtained with rocuronium. The tip and cuff of a tracheal tube were lubricated with a topical metered-dose of 8% Lidocaine pump spray. After intubation, SPO2 suddenly decreased. The chest x-ray revealed right upper lobe atelectasis. Fiber optic bronchoscopy showed that a large amount of yellow sticky mucus had been secreted into the right main bronchus.

CONCLUSIONS

In Japan, 8% Lidocaine pump spray contains menthol and ethanol as additives. These additives, particularly menthol, might have led to excessive mucus production, although we did not analyze the mucus secretion.

摘要

引言

插管后肺萎陷很常见，且由多种因素引起。

病例报告

一名21岁男性到我们手术室接受阑尾切除术。除吸烟史外，其既往史无异常。采用100%氧气、七氟醚、瑞芬太尼输注及丙泊酚诱导麻醉。使用罗库溴铵实现神经肌肉阻滞。气管导管的尖端和套囊用局部定量的8%利多卡因泵喷雾润滑。插管后，血氧饱和度（SPO2）突然下降。胸部X线显示右上叶肺不张。纤维支气管镜检查显示右主支气管内分泌了大量黄色粘性黏液。