Taki H, Shinomura T, Shirakami G
Department of Anesthesia, Kyoto University Hospital.
Masui. 1996 Oct;45(10):1247-51.
A 52-year-old female patient who was medicated chronically with sodium valproate, an anticonvulsant drug, underwent spino-peritoneal shunt operation. Firstly, spinal drain was placed under local anesthesia and with intravenous diazepam, which was antagonized by flumazenil, a specific benzodiazepine receptor antagonist, without adverse effect. Secondly, peritoneal drain was placed and shunt operation was completed under general anesthesia. After the operation flumazenil was administered again in order to accelerate anesthesia recovery. Just after the second flumazenil administration she developed generalised convulsion and coma. Convulsion disappeared immediately and full consciousness was restored several hours after the attack. We have discussed the possible mechanism of the flumazenil-induced convulsion.
一名长期服用抗惊厥药物丙戊酸钠的52岁女性患者接受了脊髓-腹腔分流手术。首先，在局部麻醉和静脉注射地西泮的情况下放置脊髓引流管，地西泮被特异性苯二氮䓬受体拮抗剂氟马西尼拮抗，未产生不良反应。其次，放置腹腔引流管，并在全身麻醉下完成分流手术。术后再次给予氟马西尼以加速麻醉恢复。就在第二次给予氟马西尼后，她出现了全身性惊厥和昏迷。惊厥立即消失，发作数小时后完全恢复意识。我们讨论了氟马西尼诱发惊厥的可能机制。
