Cho Hojae, Kim Jiyeon
Department of Anesthesiology and Pain Medicine, Inje University Ilsan Paik Hospital, Juhwa-ro 170, Ilsan Seo-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
Saudi J Anaesth. 2018 Apr-Jun;12(2):328-331. doi: 10.4103/sja.SJA_478_17.
A 37-year-old female patient, 57 kg and 160 cm, underwent laparoscopic appendectomy. In the recovery room, fentanyl 100 mcg was intravenously administered for pain control. Three minutes after the administration, the patient developed intense and uncontrolled myoclonus, lower limb rigidity, agitation, aphasia, and periocular and neck swelling. The myoclonus and rigidity were suspected to be due to the opioid administration, and thus, naloxone was administered, but the symptoms were not improved. The patient's symptoms continued until the patient received administration of physostigmine. The patient was discharged 3 days later, following resolution of the symptoms. We report a case of central anticholinergic syndrome that developed after general anesthesia owing to the interaction of opioid at an analgesic dose for postoperative pain control with another anesthetic.
一名37岁女性患者，体重57千克，身高160厘米，接受了腹腔镜阑尾切除术。在恢复室，静脉注射100微克芬太尼以控制疼痛。给药三分钟后，患者出现强烈且无法控制的肌阵挛、下肢僵硬、烦躁不安、失语以及眼周和颈部肿胀。肌阵挛和僵硬被怀疑是由于使用了阿片类药物，因此给予了纳洛酮，但症状并未改善。患者的症状一直持续，直到接受了毒扁豆碱治疗。症状缓解后，患者于3天后出院。我们报告了一例全身麻醉后因术后疼痛控制使用镇痛剂量的阿片类药物与另一种麻醉剂相互作用而发生的中枢抗胆碱能综合征病例。
