无痛分娩转剖宫产术氯普鲁卡因局麻药中毒一例

Analysis of One Case with Chloroprocaine Local Anesthetic Poisoning after Painless Delivery are Converted to Cesarean Section

目的回顾分析临床紧急事件发生的原因及处理措施,制定合理的抢救流程,提高临床警惕性,为再次发生同类事件的处理提供理论依据。方法于2016年6月无痛分娩转剖宫产术发生氯普鲁卡因局麻药中毒1例,对其积极的对症及针对性治疗:立即停止给药;充分吸氧,维持呼吸道通畅,保证组织及胎儿充足的氧供;给予咪达唑仑充分镇静;快速有效的补充血容量,使用血管活性药物,维持血流动力学稳定。结果在科室人员的协同配合下,成功抢救患者。结论严重局麻药中毒反应救治的关键在于准确判断,及早解除抽搐,保证通气与氧供,维持生命体征平稳。孕妇由于其特殊生理状况更应及时解除痉挛,保证胎儿氧需。此外,在抢救复苏过程中,医护人员的积极配合紧张有序也是抢救成功的保障。

Objective To retrospectively analyze the occurrence causes and countermeasures of clinical emergency events and provide theoretical basis for making the rational rescue course, improving the clinical alertness and handling the similar events. Methods 1 case with chloroprocaine local anesthetic poisoning after painless delivery are converted to cesarean section was given the active symptomatic and targeted treatment： stopping administration immediately, fully oxygen uptake, keeping airway open, ensuring the sufficient oxygen supply for tissues and fetuses, rapidly and effectively supplement blood capacity, using the vasoactive agents and maintaining the hemodynamic stability. Results The patients were successfully rescued in cooperation with the department personnel. Conclusion The emergency key of severe local anesthetic poisoning reaction is the accurate determination, removing clonic convulsion as soon as possible, ensuring ventilation and oxygen supply and maintaining the vital signs steady, and the delivery women especially need to timely remove the clonic convulsion and ensure the fetal oxygen demand due to their special physical condition, in addition, in the emergency and recovery course, the active and order cooperation of medical staff is the guarantee of successful emergency.