非麻醉师引起的局部麻醉系统性毒性:对病例报告的叙述性审查
Soo Hee Lee1,2, Ho Kyung Yu1,2, Ju-Tae Sohn3,4
1Department of Anesthesiology and Pain Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Journal of Korean medical science
|November 4, 2025
概括
非麻醉师过量服用局部麻醉剂,如利多卡因,特别是通过皮下或局部途径,经常导致局部麻醉系统毒性 (LAST). 及时的脂质乳液治疗显著提高了LAST患者的康复率.
科学领域:
- 麻醉学 麻醉学
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
背景情况:
- 局部麻醉剂对于疼痛管理至关重要,但可以导致致命的局部麻醉系统毒性 (LAST).
- LAST事件很少发生,但严重,对涉及非麻醉师的病例的分析有限.
- 本综述分析了由麻醉科医生以外的其他医生诱导的LAST病例报告.
研究的目的:
- 分析非麻醉学家诱导的局部麻醉系统毒性 (LAST) 的病例报告.
- 为了确定常见的局部麻醉剂,给药途径,以及在这个人群中LAST的原因.
- 为了评估LAST治疗的有效性.
主要方法:
- 对PubMed病例报告进行了系统的审查,这些病例报告涉及局部麻醉药物 (布皮瓦卡因,勒沃布皮瓦卡因,利多卡因,罗皮瓦卡因,四卡因,普里洛卡因) 的毒性.
- 搜索覆盖了截至2023年12月31日的病例,确定了53份病例报告,涉及59名患者.
- 提取和分析了麻醉类型,施用途径,原因,症状和治疗的数据.
主要成果:
- 利多卡因,特别是通过皮下透或局部应用,是非麻醉科医生中最常见的与LAST相关的药物.
- 过量服用是主要原因 (67.80%),通常涉及利多卡因.
- 接受脂质乳液治疗的患者显示100%的完全康复率,而仅接受支持性护理的患者则为73.81%.
结论:
- 非麻醉科医生的皮下或局部利多卡因过量服用是LAST的重要贡献者.
- 预防措施,包括剂量教育,风险因素识别和超声指导,至关重要.
- 随时可用的脂质乳液治疗对于在所有临床环境中有效管理LAST至关重要.
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