Neurodevelopment and Intervention of a Newborn Surviving an Event of Accidental Injection of Atracurium

一次誤打高劑量爾促開利麻醉劑的藥物事件，導致7名受害新生兒中1名死亡與6名受傷。本篇病例研究針對其中1名存活嬰兒持續出現神經發展異常，報告其於第一年追蹤期間之神經發展表現以及治療介入。個案的早期動作發展呈現較弱的頸部及下肢肌肉力量，而且各姿勢的穩定度控制差。由於個案於年齡6個月後之新動作技能的發展進程漸趨緩慢，以致後續呈現明顯的動作發展遲緩，而需接受一系列物理治療及職能治療之介入。此外，個案於年齡9個月時的腦部核磁共振攝影檢查發現胼胝體發育較慢，顯示其大腦有低髓鞘化的現象。由本篇病例報告之結果顯示，個案於誤打高劑量的爾促開利麻醉劑後，可能發生缺氧以及神經發展異常，亟需持續的發展介入以及長期的後續追蹤。

關鍵字

爾促開利；低髓鞘化；藥物事件；新生兒；神經發展

並列摘要

The occurrence of accidental injection of high doses of atracurium in seven newborns had resulted in one dead and six injured. This case report was aimed to examine the developmental course and the intervention received in one survivor who exhibited persistent abnormalities in neurodevelopment until the first year of age. The case showed weak muscle strength at the neck and the lower extremities and poor postural stability in various motor activities in the early months of age. Because of a slow progress in attaining new motor skills from 6 months onward, the infant exhibited significantly delayed motor development in later ages and hence underwent a series of physical and occupational therapy. Furthermore, she manifested thinning of corpus callosum on the brain magnetic resonance imaging at 9 months of age indicating cerebral hypomyelination. Our results appear to suggest hypoxic insult and neurodevelopmental sequel in this case following accidental injection of a high dose of atracurium. Continued developmental intervention and long-term follow-up of this case is warranted.

並列關鍵字

Atracurium ； Hypomyelination ； Medication errors ； Newborn ； Neurodevelopment

國際替代計量

Neurodevelopment and Intervention of a Newborn Surviving an Event of Accidental Injection of Atracurium

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