医学
麻醉
罗哌卡因
甲哌卡因
局部麻醉剂
腰丛
布比卡因
麻醉剂
利多卡因
神经阻滞
外科
块(置换群论)
坐骨神经
止痛药
左旋布比卡因
镇静
脊髓麻醉
臂丛神经阻滞
作者
Ch Mullanu,Patricia Lavand'homme,F. Gaillat,F. Scemama,S. Thibault,J.-P. Auffray
出处
期刊:Acta anaesthesiologica Belgica
日期:2002-01-01
卷期号:53 (3): 221-223
被引量:20
摘要
Hip fracture is a common pathology in elderly patients. Intercurrent diseases, mainly cardiac and respiratory, often result in significant morbidity and mortality. Anesthesia for hip fracture can be provided by general or regional techniques. The combination of a lumbar plexus and posterior sciatic nerve block represents an alternative to neuraxial technique of anaesthesia such as spinal anesthesia (4, 6). We report a case of acute toxicity resulting in the injection of local anesthetics Ropivacaine and Mepivacaine in elderly patient. An elderly woman was scheduled for surgical repair of a fractured femur neck by dynamic hip screw synthesis. Anesthesia was realized by peripheral nerve bi-block (lumbar plexus and posterior sciatic block) (7). The patient experienced seizures and dysrhythmias twenty minutes after block completion and injection of the anesthetic solution [Ropivacaine 0.75%, administered for lumbar plexus block performed via the posterior approach (WINNIE) and Mepivacaine 1.5%, administered for posterior sciatic nerve block (LABAT)]. Cardiopulmonary resuscitation was successful. All signs of toxicity disappeared after injection of midazolam and atropine, intubation and 100% oxygen ventilation. We decided to proceed with surgery. The postoperative course was uncomplicated and made a full recovery.
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