Weidenthal D T, King J W
Division of Ophthalmology, Saint Luke's Medical Center, Cleveland, OH 44104, USA.
Am J Ophthalmol. 1995 Oct;120(4):535-6. doi: 10.1016/s0002-9394(14)72674-1.
Cardiopulmonary arrest developed after injection of bupivacaine hydrochloride, lidocaine, and hyaluronidase in a 78-year-old woman who had previously undergone ipsilateral transcranial orbital surgery with removal of the bone of the orbital roof.
The patient required immediate cardiopulmonary resuscitation and intubation. Mechanical ventilation was necessary for 18 hours before spontaneous respirations resumed.
The patient improved and was discharged on the fifth postanesthetic day.
There were several possible mechanisms by which the local anesthetic could have entered the central nervous system. In patients with orbital roof defects, we recommend that retrobulbar anesthetic agents be used with caution.
一名78岁女性在先前接受同侧经颅眶部手术并切除眶顶骨后，注射盐酸布比卡因、利多卡因和透明质酸酶后发生心肺骤停。
患者需要立即进行心肺复苏和插管。在自主呼吸恢复前，机械通气持续了18小时。
患者病情好转，在麻醉后第五天出院。
局部麻醉药进入中枢神经系统有几种可能的机制。对于有眶顶缺损的患者，我们建议谨慎使用球后麻醉剂。
