Huang Liping, Yan Xi, Yi Mingliang
Department of Anesthesiology, Chengdu Fifth People's Hospital, Chengdu, China.
SAGE Open Med Case Rep. 2023 Mar 21;11:2050313X231160980. doi: 10.1177/2050313X231160980. eCollection 2023.
Hypertensive crisis and paroxysmal supraventricular tachycardia are serious adverse reactions that can lead to fatal consequences. We reported a 28-year-old woman who underwent emergency cesarean section of her first fetus due to pelvic outlet stenosis and had a hypertensive crisis, merging with paroxysmal supraventricular tachycardia after dezocine was administrated during the procedure. Her symptoms returned to normal after esmolol and urapidil were administrated. In order to rule out hypertension crisis caused by other diseases, the anesthesiologist immediately accessed the thyroid function, myocardial enzymes, catecholamines, and arterial blood gas analysis of the patient. No obvious abnormality was found in all the test results. We infer the conclusion that the symptoms of this patient during the operation were most likely related to dezocine administration. This case highlights the need to pay attention to possible malignant adverse reactions while using dezocine during cesarean section, and we recommend the immediate use of α-receptor blockers and/or β-receptor blockers in situations like to avoid serious complications caused by supraventricular tachycardia.
高血压危象和阵发性室上性心动过速是严重的不良反应，可导致致命后果。我们报告了一名28岁女性，因骨盆出口狭窄接受了首次剖宫产手术，术中使用地佐辛后出现高血压危象，并合并阵发性室上性心动过速。给予艾司洛尔和乌拉地尔治疗后，她的症状恢复正常。为排除其他疾病引起的高血压危象，麻醉医生立即对患者进行了甲状腺功能、心肌酶、儿茶酚胺及动脉血气分析。所有检查结果均未发现明显异常。我们推断该患者术中症状很可能与使用地佐辛有关。该病例强调了剖宫产术中使用地佐辛时需注意可能出现的恶性不良反应，我们建议在类似情况下立即使用α受体阻滞剂和/或β受体阻滞剂，以避免室上性心动过速引起的严重并发症。
