Crowe Ann-Marie, Mislovič Branislav
Department of Anaesthesiology, Critical Care and Pain Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland.
Paediatr Anaesth. 2022 Mar;32(3):479-481. doi: 10.1111/pan.14355. Epub 2021 Dec 10.
A 6-day-old, 4.0 kg neonate presented with intestinal malrotation, necessitating laparotomy. Intra-operatively, an ultrasound-guided erector spinae plane block was performed under general anesthesia with administration of 1 mg/kg levobupivacaine. Minutes following this, acute cardiac compromise was evident from a tapering end-tidal carbon dioxide, falling oxygen saturations, and low blood pressure. Intravenous epinephrine 1 mcg/kg was administered, with some hemodynamic improvement. Intralipid (1.5 ml/kg) was given, with a return to normal hemodynamic parameters. This is the first case report of suspected local anesthetic toxicity in a neonate following an erector spinae plane block.
一名6日龄、体重4.0千克的新生儿因肠旋转不良接受剖腹手术。术中，在全身麻醉下进行了超声引导下的竖脊肌平面阻滞，给予1毫克/千克的左旋布比卡因。在此之后几分钟，呼气末二氧化碳逐渐减少、血氧饱和度下降和血压降低，提示急性心脏功能不全。静脉注射1微克/千克肾上腺素后，血流动力学有所改善。给予脂肪乳剂（1.5毫升/千克）后，血流动力学参数恢复正常。这是首例关于竖脊肌平面阻滞后新生儿疑似局部麻醉药中毒的病例报告。
