Diaz J H, Connolly E S
South Med J. 1986 Dec;79(12):1554-61. doi: 10.1097/00007611-198612000-00019.
Chemonucleolysis and lumbar laminectomy after unsuccessful chemonucleolysis are now common and accepted surgical procedures that require precise perioperative management based on a thorough understanding of the pathophysiology of chymopapain-induced anaphylaxis and the herniating nucleus pulposus syndrome. Preoperative management with appropriate screening tests, antihistamines, and steroids, combined with thoughtful premedication and vigilant monitoring during local or general anesthesia, can provide safe anesthetic management of patients having chemonucleolysis with chymopapain.
化学髓核溶解术及化学髓核溶解术失败后的腰椎椎板切除术如今已成为常见且被认可的外科手术，这需要基于对木瓜凝乳蛋白酶诱发过敏反应及髓核突出综合征病理生理学的透彻理解进行精确的围手术期管理。通过适当的筛查测试、抗组胺药和类固醇进行术前管理，再结合周全的术前用药以及在局部或全身麻醉期间的密切监测，可为接受木瓜凝乳蛋白酶化学髓核溶解术的患者提供安全的麻醉管理。
