Bremang J A, Halasi S
Department of Anaesthesia, St. Joseph's Health Centre, Toronto, Ontario.
Can J Anaesth. 1995 Jul;42(7):628-30. doi: 10.1007/BF03011884.
We report the case of a 65-yr-old woman undergoing bronchoscopy for a lobular lesion who received thiopentone to induce anaesthesia that was maintained with sufentanil, vecuronium and isoflurane. She tolerated the procedure well initially, but developed eruptions about her face and fingers within 24 hr of anaesthesia. Treatment with flucinonide cream (0.05%) resolved the eruptions with no lasting sequelae. Literature review supported the suspicion that the offending agent may have been thiopentone, so when a lobectomy was subsequently required and the patient refused investigation to identify the causative agent, propofol was employed as an alternative to induce anaesthesia. The surgery was well tolerated and the patient was discharged after an uneventful postoperative course. This case is reported to heighten awareness of the delayed onset of adverse effects which may be associated with the use of thiopentone.
我们报告了一例65岁女性的病例，该患者因小叶病变接受支气管镜检查，使用硫喷妥钠诱导麻醉，并用舒芬太尼、维库溴铵和异氟烷维持麻醉。她最初对手术耐受良好，但在麻醉后24小时内面部和手指出现皮疹。使用氟轻松乳膏（0.05%）治疗后皮疹消退，无持久后遗症。文献回顾支持了罪魁祸首可能是硫喷妥钠的怀疑，因此当随后需要进行肺叶切除术且患者拒绝进行检查以确定病因时，使用丙泊酚替代硫喷妥钠诱导麻醉。手术耐受良好，患者术后恢复顺利，随后出院。报告该病例是为了提高对可能与硫喷妥钠使用相关的不良反应延迟发作的认识。
