[高剂量硬膜外和静脉注射吗啡输注导致的肌阵挛]
[Myoclonus resulting from high-dose epidural and intravenous morphine infusion].
作者信息
Radbruch L, Zech D, Grond S
机构信息
Klinik und Poliklinik für Anästhesiologic und Operative Intensivmedizin, Universität zu Köln.
出版信息
Med Klin (Munich). 1997 May 15;92(5):296-9. doi: 10.1007/BF03045086.
BACKGROUND
Myoclonus is a possible side effect of opioid therapy, and have been described following systemic as well as spinal application.
CASE REPORT
We report the case of a patient with metastatic carcinoma of the rectum who developed myoclonus following administration of high-dose epidural combined with iv morphine. This complication occurred with maximum daily doses of 300 mg epidurally and 80 mg intravenously and disappeared completely after dose reduction. Treatment trials are presented, the pathophysiology of the myoclonus is discussed.
CONCLUSION
For treatment of opioid-induced myoclonus a dose reduction or a change of the opioid should be considered as well as symptomatic treatment with benzodiazepines or baclofen.
背景
肌阵挛是阿片类药物治疗可能出现的副作用，在全身及脊髓应用后均有相关报道。
病例报告
我们报告一例直肠转移性癌患者，在给予高剂量硬膜外联合静脉注射吗啡后出现肌阵挛。该并发症发生时，硬膜外每日最大剂量为300mg，静脉注射为80mg，剂量减少后完全消失。文中介绍了治疗试验，并讨论了肌阵挛的病理生理学。
结论
对于阿片类药物诱发的肌阵挛，应考虑减少剂量或更换阿片类药物，以及使用苯二氮䓬类药物或巴氯芬进行对症治疗。
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