- 期刊
A Rare Complication of Intravenous Regional Anesthesia Due to Tourniquet Dysfunction-A Case Report
止血帶失效導致區域靜脈麻醉之合併症－少見之病例報告
摘要
一位60歲婦女因左手腕道症候群住院，採用雙環帶止血帶(double cuffed tourniquet)使用40cc，0.5% xylocaine為麻醉劑，施行區域靜脈麻醉(IVRA)。當止血帶增壓上磅(250 mmHg)及麻醉劑靜脈注射後，左側上肢發生腫脹，遍佈瘀斑及小出血點。我們決定鬆解止血帶，改由全身麻醉方式進行正中神經減壓手術。病人於第二天出院，但左手及手臂瘀血點持續兩週以上，至手術後第四週時完全恢復正常。我們回顧有關文獻，建議施行區域靜脈麻醉時，應注意其可能之危險與合併症。全身麻醉之儀器設備及治療心肺復甦、中樞神經中毒之藥物，亦必須準備隨時應用。
關鍵字
無資料並列摘要
A 60 year old female was admitted under the diagnosis of carpal tunnel syndrome. Intravenous regional anesthesia (IVRA) was given using a double cuffed tourniquet (7.5 cm cuff and 18 cm in length), and 40 ml of 0.5% lidocaine. After the tourniquet was inflated (250 mmHg) and the anesthetic agent was injected, the patient's left forearm became swollen and ecchymotic spots appeared all over the forearm. We released the tourniquet and the surgical procedure (decompression of median nerve) was performed under general anesthesia (GA). The patient was discharged on the 2(superscript nd) post operation day. The petechiae persisted for 2 weeks, however by the 4(superscript td) week post operation, the forearm and hand were completely recovered without any motor or sensory deficit. We suggest that physicians be aware of the potential risk of IVRA and its complications. When performing hand surgery under IVRA, the appropriate equipment and drugs should be available in case the need to switch to GA. Also, drugs used for cardiopulmonary resuscitation or central nervous system intoxication should be ready.
延伸閱讀
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