局部麻醉剂在儿童中的全身毒性:对法国药监数据库的分析
Arnaud Schweitzer-Chaput1, Delphine Callot1, Naim Bouazza2,3
1Centre Régional de Pharmacovigilance, Service de Pharmacologie, Hôpital Cochin, AP-HP, Paris, France.
儿科局部麻醉系统性毒性 (LAST) 是罕见的,但即使在推剂量下,也可能危及生命. 手术类型和麻醉剂对经历LAST的儿童的影响.
科学领域:
- 麻醉学 麻醉学
- 儿科药理学 儿科药理学
- 药物监督 药物监督 药物监督
背景情况:
- 局部麻醉系统性毒性 (LAST) 是一种罕见但严重的并发症.
- 了解儿童LAST的临床特征和风险因素对于患者的安全至关重要.
研究的目的:
- 描述儿科局部麻醉系统毒性 (LAST) 的临床表现.
- 为了确定与儿童LAST病例中危及生命的结果相关的因素.
主要方法:
- 法国药监网络自发报告的回顾性分析.
- 纳入标准:儿科患者 (<18岁) 怀疑LAST,重点是神经,心脏和全身不良事件.
- 多变量逻辑回归用于确定危及生命的反应的决定因素 (发作,心肺呼吸停止).
主要成果:
- 确定了64例儿科LAST病例,主要涉及利多卡因和利多卡因+普洛卡因.
- 神经 (58%) 和心脏 (11%) 症状是最常见的;11%的人患有甲基血球血.
- 36%的病例是危及生命的,手术类型和麻醉剂独立地与严重的结果相关.
结论:
- 儿科LAST是一种罕见的事件,主要是神经和心脏表现.
- 无论剂量如何,LAST在儿童中都可能危及生命,这凸显了谨慎管理的重要性.
- 虽然致命的结果很少见,但在大多数情况下,及时的医疗护理会导致康复.
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