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球周阻滞并发症:脑干麻醉

Complication of Peribulbar Block: Brainstem Anaesthesia.

作者信息

Kazancıoğlu Leyla, Batçık Şule, Kazdal Hızır, Şen Ahmet, Gediz Berrak Şekeryapan, Erdivanlı Başar

机构信息

Department of Anaesthesiology and Reanimation, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

Department of Eye Diseases, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2017 Aug;45(4):231-233. doi: 10.5152/TJAR.2017.95881. Epub 2017 Aug 1.

Abstract

Peribulbar block is used to obtain anaesthesia and akinesia of the eye by injecting a local anaesthetic around the musclecone. A patient scheduled for cataract surgery received peribulbar block with 6 mL of 2% lidocaine hydrochloride. Following the injection, confusion, hypotension and dilatation of the contralateral pupil rapidly progressed to loss of consciousness and respiratory arrest. The patient was intubated and mechanically ventilated for 30 min. The patient regained her consciousness, was extubated and transferred to the intensive care unit for further follow-up. Although brainstem anaesthesia because of peribulbar block is very rare, this procedure should be performed with complete monitorisation and resuscitation equipment.

摘要

球周阻滞是通过在肌锥周围注射局部麻醉剂来实现眼部麻醉和运动不能。一名计划进行白内障手术的患者接受了6毫升2%盐酸利多卡因的球周阻滞。注射后,患者迅速出现意识模糊、低血压和对侧瞳孔散大,进而发展为意识丧失和呼吸骤停。患者接受了气管插管并机械通气30分钟。患者恢复意识,拔管后转至重症监护病房进一步随访。尽管球周阻滞导致的脑干麻醉非常罕见,但该操作应在配备完善的监测和复苏设备的情况下进行。

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Complication of Peribulbar Block: Brainstem Anaesthesia.球周阻滞并发症:脑干麻醉
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本文引用的文献

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Ophthalmic regional blocks: management, challenges, and solutions.眼科局部阻滞:管理、挑战与解决方案。
Local Reg Anesth. 2015 Aug 20;8:57-70. doi: 10.2147/LRA.S64806. eCollection 2015.
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Peribulbar versus retrobulbar anaesthesia for cataract surgery.白内障手术的球周麻醉与球后麻醉对比
Cochrane Database Syst Rev. 2015 Jul 2;2015(7):CD004083. doi: 10.1002/14651858.CD004083.pub3.
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Brainstem anesthesia presenting as contralateral third nerve palsy following peribulbar anesthesia for cataract surgery.
Acta Anaesthesiol Taiwan. 2013 Sep;51(3):135-6. doi: 10.1016/j.aat.2013.08.002. Epub 2013 Sep 13.
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[Brainstem anesthesia after extraconal retrobulbar block: can it be avoided? Case report].
Rev Bras Anestesiol. 2007 Aug;57(4):391-400. doi: 10.1590/s0034-70942007000400006.
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Orbital regional anesthesia: complications and their prevention.眼眶区域麻醉:并发症及其预防
Indian J Ophthalmol. 2006 Jun;54(2):77-84. doi: 10.4103/0301-4738.25826.
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[Brainstem anesthesia after peribulbar anesthesia].球后麻醉后的脑干麻醉
Ann Fr Anesth Reanim. 2002 Nov;21(9):725-7. doi: 10.1016/s0750-7658(02)00782-7.

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