严重的低血压和手术后心脏骤停由5-氨基诺列维林酸引起:一个病例报告
Taishi Miyazaki1, Shinya Taguchi2, Norihiko Obata1
1Department of Anesthesiology, Kobe University Hospital, 7-5-1 Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Journal of medical case reports
|May 29, 2024
概括
用于膀瘤诊断的5-aminolevulinic酸可以导致严重的低血压. 这一案例突显了手术后心脏骤停的风险,强调了在服用这种药物后接受手术的患者的谨慎血液动力学管理.
科学领域:
- 在瘤学瘤学.
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 5 - 氨基乙烯酸 (ALA) 是一种光敏感剂,用于膀瘤的光动力学诊断.
- 服用ALA经常会导致严重的手术内低血压.
- 这一案例显示了ALA使用与术后心脏骤停之间的潜在联系.
研究的目的:
- 报告一种罕见的术后心脏骤停病例,该病例发生在为膀瘤切除而给予5氨基利武林酸后.
- 为了强调在接受ALA的患者中保持警的术后血动力学监测的重要性.
主要方法:
- 一名81岁的男性患者通过尿道切除了膀瘤.
- 患者在手术前两小时接受了口服的5 - 氨基氨酸.
- 诱导了麻醉,导致严重的低血压,对血管压缩剂没有反应.
主要成果:
- 患者经历了严重的低血压 (47/33 mmHg) 后麻醉诱导.
- 经过手术和麻醉后恢复,患者在返回病房大约五小时后,心脏骤停了12秒.
- 心脏骤停发生了,尽管最初的静缩血压稳定.
结论:
- 手术后心脏骤停可能是与使用5 - 氨基诺列维氨酸相关的并发症.
- 在这种情况下,心脏骤停的确切机制尚不清楚.
- 对于接受5 - 氨基乙烯酸的患者来说,仔细的外科手术期间的血液动力学管理至关重要.
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
Local Anesthetics: Adverse Effects
411
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
411
Blood Pressure Imbalances and Circulatory Shock
769
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
769
Prevention of Further Absorption of Poison
817
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
817


