Case Report: Lidocaine Patch Relieves Local Propofol Extravasation Pain

使用利多卡因貼片緩解局部異丙酚外滲的疼痛感

陳家耀(Chia-Yao Chen) ； 王瑞琪(Juei-Chii Wang) ； 王瑞平(Juei-Pin Wang) ； 汪志雄(Chih-Shung Wong)

《疼痛醫學雜誌》 25卷1期 (2015/03) Pp. 48-53

摘要

基於諸多的優點，異丙酚乳化劑是最常用的靜脈麻醉藥物之一，這尤其常用於需要鎮靜的術式，例如內視鏡檢查。而靜脈藥物在意外的情況下外滲到周圍的組織會造成一些後遺症，一般多相對輕微，但也有些藥物可能會引起嚴重的傷害， 例如壞死， 軟組織損失，和癥痕形成導致的學縮手口畸形。雖然並沒有太多的報告提及異丙酚外滲所造成的傷害情況，這也許與異丙盼的某些特性有關；然而異丙酚於注射時的疼痛感是最常見的副作用之一，尤其發生在較小的靜脈上。當異丙酚外滲發生時，疼痛和外滲部位的腫脹是必須加以考慮的。這個病例報告描述，於胃腸鏡健康檢查進行鎮靜麻醉時，有異丙酚外滲的情況。使用利多卡因貼片可以立即緩解異丙酚外滲部位的疼痛，且無任何後遺症。雖然發生異丙酚外滲事件，但病患對於處置上並無想言且給予高度滿意。

關鍵字

異丙酚 ； 靜脈外滲 ； 利多卡因貼片

並列摘要

Because of many advantages, propofol injectable emulsion is one of the most commonly used intravenous anesthetics, and particularly uses for procedural sedation, such as endoscopic procedures. In spite of minor sequelae to most cases, extravasations, accidentally leaks of intravenous medication to the surrounding tissue, in some drugs, could cause serious injuries, such as necrosis induced by barbiturates, soft tissue loss, and scarring leading to contractures and deformity. Although carrying its favorable properties, extravasation injuries with propofol were relatively rare, pain on injection is still one of propofol's most frequent side effects, especially in smaller veins. When propofol extravasation occurs, pain and swelling at the leakage site must considerate. Here, we report a case of suspected propofol extravasation during gastroscopy and colonscopy for health examination. Lidocaine patch was applied and provided a fast and comforting pain relief. It also provided high patient and anesthesiologist satisfaction without significant adverse effects.

並列關鍵字

propofol ； extravasation ； lidocaine patch