- 期刊
Factors Associated with Intraoperative Bronchospasm
術中支氣管痙攣之誘發因子
摘要
術中支氣管痙攣是麻醉過程中罕見之緊急危況。它可能以不同之方式出現或可能與過敏或過敏性反應有關，並發展成危及生命的情況。它通常是被呼吸道的機械性刺激或藥物或手術中使用的許多物質所誘發。麻醉所用之麻醉藥物及插管動作皆可能會誘發支氣管痙攣，但約有三分之一的案例無法鑑別出真正誘發的原因。我們報告一個年輕男性在全身麻醉狀態下給予頭孢菌素類抗生素cephalexin之後產生了術中支氣管痙攣。Cephalexin起先被認為是誘發的原因，但我們又持續用它治療了三天，病患在此期間恢復良好無任何不適。如此一來對於這次術中支氣管痙攣案例之誘發因子的鑑定變得很困難。我們就此一罕見之術中支氣管痙攣的臨床表現、各種誘發因素、可能的誘發因子鑑別之困難、臨床之鑑別診斷、治療方法及預後做一文獻回顧及討論。
並列摘要
Intraoperative bronchospasm is a rare but urgent crisis during anesthesia. It may present in different ways and can be associated with allergy or anaphylaxis which develops life threatening conditions. It can be triggered by mechanical airway irritation, anesthetics, intraoperative antibiotics, latex or lots of substances applied during operation. Anesthesia including the anesthetics and intubation maneuver all contribute the accident, but the exact causative agent could not be identified in probably one third of the cases. We report a young patient who developed bronchospasm immediately after the administration of cephalexin during general anesthesia. Initially cephalexin was thought to be the causative agent due to the time sequence. However, we continued to use the same antibiotic for another 3 days without any unwanted side effects. Therefore, how to find and make differential diagnoses of the trigging factors is very difficult. We will make the literature reviews and discuss the manifestations of the bronchospasm, the related inducing factors, the difficulties of the specified identification of the possible agents, the differential diagnoses, the managements of this rare crisis during general anesthesia and the prognosis.