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门诊手术护理中出现的精神状态改变和四肢瘫痪:一例报告

Altered Mental Status and Quadriparesis in Ambulatory Surgical Care: A Case Report.

作者信息

Torrinha Gonçalo, Vieira Rui, Pacheco Cecília, Vilaça Cecília, Bernardo Sara

机构信息

Department of Intensive Care Medicine, Unidade Local de Saúde de Braga, Braga, PRT.

School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, PRT.

出版信息

Cureus. 2025 Jun 22;17(6):e86530. doi: 10.7759/cureus.86530. eCollection 2025 Jun.

Abstract

This case report describes a rare instance of local anesthetic systemic toxicity (LAST) following subcutaneous lidocaine administration for a minor surgical procedure. A 70-year-old male patient developed agitation, dysarthria, and quadriparesis postoperatively, with subsequent investigations revealing a pneumothorax but no major neurological or vascular compromise. The diagnosis of LAST was made after exclusion of other causes. The patient recovered fully within hours without any specific management. This case underscores the need for improved awareness of LAST among non-anesthesiology clinicians and emphasizes preventive strategies for local anesthetic use.

摘要

本病例报告描述了在一次小型外科手术中皮下注射利多卡因后发生罕见的局部麻醉药全身毒性反应(LAST)的案例。一名70岁男性患者术后出现躁动、构音障碍和四肢瘫,随后的检查发现有气胸,但无重大神经或血管损伤。在排除其他原因后做出了LAST的诊断。患者在数小时内完全康复,未进行任何特殊处理。本病例强调了非麻醉科临床医生提高对LAST认识的必要性,并强调了局部麻醉药使用的预防策略。

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