非常低剂量的芬太尼导致芬太尼诱导的胸壁刚性的案例报告
Ronza Zoorob1, Logan Uptegrove1, Benjamin L Park2
1Anesthesia, Lake Erie College of Osteopathic Medicine, Indiana, USA.
Cureus
|September 21, 2023
概括
木制胸部综合征 (WCS) 是一种罕见的阿片类药物副作用,可能导致呼吸衰竭. 这个案例突出了WCS发生在一个非常低的芬太尼剂量在一个老年患者与先前存在的神经疾病.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 木制胸部综合征 (WCS) 是一种罕见但严重的阿片类药物诱导的骨肌硬度.
- 芬太尼是一种强大的合成阿片类药物,经常与WCS有关,特别是在重症监护和手术环境中.
- 由于芬太尼的广泛使用,了解芬太尼的副作用和WCS倾向因素至关重要.
研究的目的:
- 报告WCS发生在异常低剂量的芬太尼的病例.
- 在患有先前存在的神经疾病的患者中探索潜在的WCS倾向因素.
- 强调承认WCS的重要性,即使在呼吸暂停的亚治疗剂量中也是如此.
主要方法:
- 案例报告的呈现方式.
- 审查患者的病史,包括慢性炎症性脱髓化多神经病变 (CIDP) 和吉兰-巴雷综合征 (GBS).
- 芬太尼的剂量和临床表现的分析.
主要成果:
- 在80岁的患者中观察到WCS,芬太尼剂量为50μcg (0.49μcg/kg).
- 该患者有CIDP和GBS病史,这表明潜在的神经因素可能会导致这种情况.
- WCS症状表现为比通常与呼吸系统抑郁相关的芬太尼度明显低.
结论:
- 在极低的芬太尼剂量下,WCS可能会发生,这挑战了以前的剂量反应假设.
- 患有潜在神经疾病的患者,如CIDP和GBS,可能会增加WCS的风险.
- 对于WCS的警是有必要的,即使是最小的芬太尼剂量,特别是在脆弱的患者群体.
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