丙泊酚治疗骶管阻滞引起局麻药中毒的临床经验

Clinical experience of propofol in treatment of local anesthetic toxicity induced by sacral block

目的探讨丙泊酚在治疗骶管阻滞引起局麻药中毒的应用。方法回顾分析我科2002年1月～2010年11月期间应用丙泊酚治疗22例骶管阻滞引起局麻药中毒病例，以1997年9月～2002年5月地西泮治疗的18例骶管阻滞引起局麻药中毒病例为对照组，观察两组给药后治疗情况，监测给药前（T1）及给药后3（T2）、5（T3）、10min（T4）和20min（T5）各时间点生命体征的变化[心率（HR）、血氧饱和度（SpO2）、平均动脉压（MAP）]。结果两组局麻药中毒症状均得到有效控制，丙泊酚组的中毒症状消失时间（15±6）s和患者清醒时间（6±4）min均明显低于地西泮组（P〈0．01）。结论静脉注射丙泊酚能有效控制骶管阻滞引起局麻药中毒的毒性反应，能迅速改善中毒症状，是一种有前景的治疗措施。

Objective To study the effect of propofol in treatment of local anesthetic toxicity induced by sacral block. Methods We retrospectively analyzed 22 cases （P） who had experienced local anesthetic toxicity induced by sacral block and received a treatment of propofol in our department from January 2002 to November 2010. Other 18 patients （D） who received diazepam therapy from September 1997 to May 2002 were taken as the control. Those data of HR, SpO2 and MAP which were measured immediately prior to, 3, 5, 10 and 20 rain after drug administration were analyzed. Results The symptoms of local anesthetic toxicity induced by sacral block were treated effectively in both groups. However, the time of toxic symptoms withdrawl （15±6） s and awakening （6±4） min were significantly shorter in group P（P〈0.01 ）. Conclusions Local anesthetic toxicity induced by sacral block can he effectively treated, and toxic symptom quickly can be corrected by intravenous injection of propofol. Thus, it may become a promising treatment.