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[组胺释放与麻醉学中使用的药物之间的相互干扰。组胺释放并发症的预防和治疗]

[Interference between histamine liberation and drugs used in anesthesiology. Prevention and treatment of the complications of histamine liberation].

作者信息

Doenicke A, Lorenz W

出版信息

Ann Anesthesiol Fr. 1976;17(3):355-64.

PMID:62543
Abstract

The authors report the complications associated with the administration of some anaesthetics using propanidide. In one of the controls, premedication using an antihistamine was sufficient to avoid, during a third administration of propanidide, complications which included a fall in blood pressure and which had occurred when the second anaesthetic had been given. In one patient with high plasma histamine concentrations, circulatory arrest occurred during the second and third anaesthetic, despite meclastinum. Only the addition of a glucocorticoid to the premedication made possible an anaesthetic without problems. During a third propanidide anaesthetic given to this same patient, we were able to confirm our hypothesis by a premedication combining meclastinum and a glucocorticoid, despite the high plasma histamine level found. In certain other cases, however, plasma histimine concentration did not increase despite the development of erythema and urticaria of the face and neck. Serious complications were successfully dealt with using a combination of glucocorticoids, adrenaline derivatives and an antihistamine.

摘要

作者报告了使用丙泮尼地给药某些麻醉剂相关的并发症。在其中一个对照组中,使用抗组胺药进行术前用药足以避免在第三次给予丙泮尼地时出现并发症,这些并发症包括血压下降,且在第二次给予麻醉剂时就已出现。在一名血浆组胺浓度较高的患者中,尽管使用了甲氯苄胺,在第二次和第三次麻醉期间仍发生了循环骤停。只有在术前用药中添加糖皮质激素才能实现无问题的麻醉。在给该同一患者第三次使用丙泮尼地麻醉时,尽管发现血浆组胺水平较高,但通过将甲氯苄胺和糖皮质激素联合进行术前用药,我们能够证实我们的假设。然而,在某些其他情况下,尽管面部和颈部出现红斑和荨麻疹,但血浆组胺浓度并未升高。使用糖皮质激素、肾上腺素衍生物和抗组胺药的组合成功处理了严重并发症。

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