Acevedo Fidel A, Kim Esther J, Chyatte David A, Nielsen Vance G
The Department of Anesthesiology, University of Arizona College of Medicine, P.O. Box 245114, 1501 North Campbell Avenue, Tucson, AZ, 85724-5114, USA.
Int J Legal Med. 2018 May;132(3):767-769. doi: 10.1007/s00414-017-1682-7. Epub 2017 Sep 5.
We present a case of a patient administered parasternal transdermal lidocaine patch therapy as part of a multimodal analgesic regime designed to diminish opioid-associated delirium after coronary bypass surgery. The patient presented with delirium and severe methemoglobinemia (41%) that responded to discontinuation of lidocaine therapy, oxygen administration, and methylene blue administration. The clinical contributors and medicolegal implications of this degree of lidocaine-associated methemoglobin-mediated delirium are presented in the hope of avoiding similar complications in the postoperative setting after coronary bypass surgery.
我们报告了一例患者，该患者接受胸骨旁经皮利多卡因贴剂治疗，这是旨在减少冠状动脉搭桥手术后阿片类药物相关谵妄的多模式镇痛方案的一部分。该患者出现谵妄和严重高铁血红蛋白血症（41%），停用利多卡因治疗、给予氧气和亚甲蓝后症状得到缓解。本文介绍了这种程度的利多卡因相关高铁血红蛋白介导的谵妄的临床因素和法医学意义，以期避免冠状动脉搭桥手术后类似并发症的发生。
