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超声引导下球后阻滞术后猫可能发生的脑干麻醉

Possible Brainstem Anaesthesia in a Cat after Ultrasound-Guided Retrobulbar Block.

作者信息

Papastefanou Anastasia, Rioja Eva

机构信息

Optivet Referrals, Ltd., Havant PO9 2NJ, UK.

出版信息

Animals (Basel). 2023 Feb 21;13(5):781. doi: 10.3390/ani13050781.


DOI:10.3390/ani13050781
PMID:36899638
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10000029/
Abstract

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.

摘要

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。

相似文献

[1]
Possible Brainstem Anaesthesia in a Cat after Ultrasound-Guided Retrobulbar Block.

Animals (Basel). 2023-2-21

[2]
Suspected brainstem anesthesia following retrobulbar block in a cat.

Vet Ophthalmol. 2013-5

[3]
Brainstem Anaesthesia after Retrobulbar Block.

Open Med (Wars). 2019-3-2

[4]
The Outcomes of an Opioid-Free Anaesthetic Plan in Fourteen Dogs Undergoing Enucleation Using an Ultrasound-Guided Supra-Temporal Retrobulbar Block: A Retrospective Case Series.

Animals (Basel). 2023-6-22

[5]
A Case of Brainstem Anesthesia after Retrobulbar Block for Globe Rupture Repair.

Case Rep Anesthesiol. 2021-12-13

[6]
[General anesthesia vs. retrobulbar anesthesia in cataract surgery. A randomized comparison of patients at risk].

Anaesthesist. 1992-8

[7]
Delayed convulsions and brief contralateral hemiparesis after retrobulbar block.

Reg Anesth Pain Med. 2006

[8]
Brainstem anaesthesia after retrobulbar block: a rare cause of coma presenting to the emergency department.

Emerg Med Australas. 2006-2

[9]
Brainstem Anesthesia During Retrobulbar Block: An Eye-Opener Clinical Case.

Cureus. 2024-8-6

[10]
Effect of retrobulbar nerve block on heart rate variability during enucleation in horses under general anesthesia.

Vet Ophthalmol. 2014-5

引用本文的文献

[1]
Perioperative analgesic effects of a modified supratemporal retrobulbar block in dogs undergoing corneal and endocular surgery.

J Small Anim Pract. 2025-5

[2]
Blind supratemporal retrobulbar block in cats: a feasibility cadaveric study and its efficacy in a group of subjects undergoing corneal or intraocular surgery.

Front Vet Sci. 2024-11-22

本文引用的文献

[1]
Mechanisms of respiratory depression induced by the combination of buprenorphine and diazepam in rats.

Br J Anaesth. 2022-3

[2]
A modified retrobulbar block for microphthalmia using ultrasound guidance in a cat.

Vet Anaesth Analg. 2020-11

[3]
Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1).

Vet Med Sci. 2020-5

[4]
Ultrasound-guided posterior extraconal block in the dog: anatomical study in cadavers.

Vet Anaesth Analg. 2019-3

[5]
A review of ophthalmic local and regional anesthesia in dogs and cats.

Vet Anaesth Analg. 2019-1

[6]
Lipid Emulsion for Treating Local Anesthetic Systemic Toxicity.

Int J Med Sci. 2018-5-14

[7]
Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs.

Vet Ophthalmol. 2019-3

[8]
A novel supra-temporal approach to retrobulbar anaesthesia in dogs: Preliminary study in cadavers.

Vet J. 2017-5

[9]
Effects of γ-Aminobutyric Acid Type A Receptor Modulation by Flumazenil on Emergence from General Anesthesia.

Anesthesiology. 2016-7

[10]
Comparison of anesthetic efficacy and adverse effects associated with peribulbar injection of ropivacaine performed with and without ultrasound guidance in dogs.

Am J Vet Res. 2014-12

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