门诊静脉切除术。局部麻醉的一种罕见并发症：病例报告及文献综述。
Ambulatory phlebectomy. A rare complication of local anesthetic: case report and literature review.
作者信息
Olivencia J A
机构信息
Iowa Vein Center, Mercy West Health Center, Des Moines, USA.
出版信息
Dermatol Surg. 1996 Jan;22(1):53-5.
BACKGROUND
Full-thickness skin necrosis can occur after infiltration of 1.0% lidocaine with 1/100,000 epinephrine for ambulatory phlebectomy.
OBJECTIVE
To demonstrate an exaggerated local response to epinephrine resulting in full-thickness skin necrosis and ultimately a permanent scar.
METHODS
A postoperative complication was clinically observed.
CONCLUSION
Permanent scar formation after ambulatory phlebectomy was found in a patient with a previous probable exaggerated local response to epinephrine. Uneventful phlebectomy resulted in the same patient when epinephrine was deleted from the local anesthetic, suggesting a local inability to eliminate epinephrine or an exaggerated local alpha-one response.
背景
门诊静脉切除术使用含1/100,000肾上腺素的1.0%利多卡因浸润后可发生全层皮肤坏死。
目的
证明对肾上腺素的局部反应过度导致全层皮肤坏死并最终形成永久性瘢痕。
方法
临床观察术后并发症。
结论
一名既往可能对肾上腺素局部反应过度的患者在门诊静脉切除术后出现永久性瘢痕形成。当局部麻醉剂中不使用肾上腺素时，同一名患者的静脉切除术顺利进行，提示局部存在肾上腺素清除能力不足或局部α-1反应过度。
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