芬太尼透皮贴剂引起意识丧失

Unconsciousness due to transdermal fentanyl patches

1例59岁乳腺癌患者,因腰背部疼痛加剧,给予芬太尼透皮贴剂1贴(8.4 mg)。30 min后患者入睡,持续约4 h患者突然出现意识丧失,头向后上仰,颈项强直,四肢抽搐,双侧瞳孔缩小,对光反射迟钝,呼吸深、慢(6～7次/min),脉搏血氧饱和度下降至0.77。考虑和芬太尼过量有关。立即去除芬太尼透皮贴剂,给予吸氧,静脉注射纳洛酮0.2 mg。之后,患者四肢抽搐缓解,呼吸升至18次/min,意识恢复,无肢体感觉、运动功能障碍。

A 59 year-old woman with breast cancer received a patch of transdermal fentanyl（8.4 mg） for back and loin pain control.Thirty minutes later,she fall asleep and,about 4 hours later,she becam e unconscious accompanied with head backwards position,stiffness of neck,tetan y,bilateral miosis,a sluggish papillary light reflex,and a slow respiratory r ate（6-7 breaths/min）;her SpO2 decreased to 0.77.The above-mentioned adverse reactions were considered to be related to fentanyl overdose.The patch of transdermal fentanyl was removed immediately.Oxygen inhalation and IV naloxone 0. 2 mg were given.Subsequently,the patient＇s tetany relieved and her respiratory rate increased to 18 breaths/min.She regained consciousness and there was no abnormality in her sensory and motor functions.