Papastefanou Anastasia, Rioja Eva
Optivet Referrals, Ltd., Havant PO9 2NJ, UK.
Animals (Basel). 2023 Feb 21;13(5):781. doi: 10.3390/ani13050781.
A 13-year-old neutered, blue-eyed female Siamese cat with a bodyweight of 4.8 kg was admitted for enucleation of the right eye. An ultrasound guided retrobulbar block with 1 mL of ropivacaine was performed under general anaesthesia. When the tip of the needle was visualised inside the intraconal space, negative aspiration of the syringe before injection and no obvious resistance during injection were confirmed. Instantly, after ropivacaine was administered, the cat became apnoeic, and its heart rate and the blood pressure increased significantly for a short period of time. During surgery, the cat needed cardiovascular support to maintain blood pressure and was under continuous mechanical ventilation. Spontaneous breathing returned 20 min after the end of anaesthesia. Brainstem anaesthesia was suspected, and after recovery, the contralateral eye was examined. A reduced menace response, horizontal nystagmus, mydriasis, and absence of the pupillary light reflex were present. The following day, mydriasis was still present, but the cat was visual and was discharged. The inadvertent intra-arterial injection of ropivacaine was suspected to be the cause of the spread into the brainstem. To the current authors' knowledge, possible brainstem anaesthesia has only been reported in a cat 5 min after a retrobulbar block but never instantly.
一只13岁已绝育、蓝眼的雌性暹罗猫,体重4.8千克,因右眼眼球摘除术入院。在全身麻醉下,用1毫升罗哌卡因进行了超声引导下的球后阻滞。当在锥内间隙看到针尖时,确认注射前注射器回抽无血且注射时无明显阻力。在给予罗哌卡因后,猫立即出现呼吸暂停,心率和血压在短时间内显著升高。手术过程中,猫需要心血管支持以维持血压,并持续进行机械通气。麻醉结束20分钟后恢复自主呼吸。怀疑发生了脑干麻醉,恢复后对侧眼进行了检查。出现了威胁反应减弱、水平性眼球震颤、瞳孔散大以及瞳孔对光反射消失。第二天,瞳孔散大仍然存在,但猫视力正常并出院。怀疑罗哌卡因意外动脉内注射是药物扩散至脑干的原因。据本文作者所知,可能的脑干麻醉仅在球后阻滞后5分钟的一只猫中报道过,但从未有过立即发生的情况。
Animals (Basel). 2023-2-21
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