一名患有斜颈-肌张力障碍疾病的患者在丙泊酚麻醉期间出现难治性肌张力障碍。
Refractory dystonia during propofol anaesthesia in a patient with torticollis-dystonia disorder.
作者信息
Zabani I, Vaghadia H
机构信息
Department of Anaesthesia, Vancouver Hospital and Health Sciences Centre, University of British Columbia, Canada.
出版信息
Can J Anaesth. 1996 Oct;43(10):1062-4. doi: 10.1007/BF03011910.
PURPOSE
To report a case of refractory dystonia under propofol anaesthesia in a patient with Torticollis-Dystonia disorder.
CLINICAL FEATURES
A 38-yr-old man presented for an MRI scan for investigation of a Torticollis-Dystonia disorder. There was a biphasic response to propofol with complete amelioration of the torticollis and limb dystonia initially with subsequent recurrence under deep propofol anaesthesia. Coadministration of midazolam, diazepam, and thiopentone were not successful in abolishing the recurrent dystonia.
CONCLUSIONS
Propofol should preferably be avoided in patients with torticollis and dystonias. Where complete control of movements is required, it may be necessary to consider general endotracheal anaesthesia with muscle relaxants.
目的
报告1例患有斜颈-肌张力障碍疾病的患者在丙泊酚麻醉下出现难治性肌张力障碍的病例。
临床特征
一名38岁男性因斜颈-肌张力障碍疾病接受MRI扫描。丙泊酚诱导呈现双相反应，最初斜颈和肢体肌张力障碍完全缓解，但在深度丙泊酚麻醉下随后复发。联合使用咪达唑仑、地西泮和硫喷妥钠未能消除复发性肌张力障碍。
结论
斜颈和肌张力障碍患者应尽量避免使用丙泊酚。在需要完全控制运动的情况下，可能有必要考虑使用肌肉松弛剂进行全身气管内麻醉。
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