Breithardt G, Seipel L, Schulte H D, Lautenschläger J
Z Kardiol. 1975 Jul;64(7):691-4.
A side reaction of antiarrhythmic treatment in a 18-year-old patient with congestive cardiomyopathy is reported. During treatment with high doses of aprindine cerebral convulsions occurred. After ceasing the medication temporarily, a pacemaker revision was done in local anesthesia. Cerebral convulsions reappeared after injection of the local anesthetic. The patient died due to cardiac arrest. It is discussed that some amount of the local anesthetic agent (mepivacaine) was absorbed from the tissue elevating the blood level of local anesthetic drugs (aprindine and mepivacine) into the toxic range, thus producing cerebral convulsions, augmenting the stimulation threshold and depressing the automaticity of the heart. It is urged that antiarrhythmic treatment should be stopped before local anesthesia will be performed.
报道了一名18岁充血性心肌病患者抗心律失常治疗的副作用。在高剂量使用安搏律定治疗期间出现了脑部惊厥。暂时停药后，在局部麻醉下进行了起搏器修复术。注射局部麻醉剂后脑部惊厥再次出现。患者因心脏骤停死亡。据讨论，一定量的局部麻醉剂（甲哌卡因）从组织中吸收，使局部麻醉药物（安搏律定和甲哌卡因）的血药浓度升高至中毒范围，从而产生脑部惊厥，提高刺激阈值并抑制心脏自律性。强烈建议在进行局部麻醉前停止抗心律失常治疗。
