盐酸多沙普仑注射液致过敏性休克

Anaphylactic shock due to doxapram hydrochloride injection

1例40岁女性患者被诊断患有左乳癌，接受改良根治术。患者手术进行顺利，生命体征平稳。术后，静脉注射盐酸多沙普仑注射液100 mg（约1 min注射完毕）以促使患者从麻醉状态中苏醒。注射结束后约5 min患者出现休克，血压波动于60-74/46-54 mmHg（1 mmHg=0.133 kPa），血氧饱和度（SO2）波动于0.58-0.74；双肺满布湿啰音。立即给予面罩吸氧和肾上腺素40 μg、呋塞米40 mg、地塞米松10 mg静脉注射；多巴胺80 mg溶于0.9%氯化钠注射液 20 ml中，以8 ml/h速度静脉泵入。20 min后，患者两肺湿啰音明显减少，血压为86/52 mmHg，SO2波动于0.84-0.91。术后第2天，患者血压110/70 mmHg，SO2 0.98，心率70-80次/min；听诊双肺呼吸音粗，右下肺闻及少许湿啰音。术后第5天，患者病情平稳且伤口愈合良好而出院。

A 40-year-old female patient was diagnosed as having left breast cancinoma and underwent modified radical mastectomy. The patient′s surgical procedure was uneventful and her vital signs were stable. After the operation, doxapram hydrochloride 100 mg injection was given by intravenous injection （about 1 minute of completing the injection） to accelerate the patient recovering from the anesthesia. The patient developed shock about 5 minutes after the injection. Her blood pressure fluctuated between 60/46 and 74/54 mmHg, blood oxygen saturation fluctuated between 58% and 74%, and wet rales were audible over both lungs. The patient immediately received oxygen inhalation via a facemask and intravenous injection of adrenaline 40 μg, furosemide 40 mg, and dexamethasone 10 mg. In addition, dopamine 80 mg dissolved in 20 ml of 0.9% sodium chloride injection was administered intravenously via an infusion pump at a rate of 8 ml/h. Twenty minutes later, the patient′s moist rales in both lungs were significantly reduced, her blood pressure was 86/52 mmHg, and oxygen saturation fluctuated between 0.84 and 0.91. On postoperative day 2, the patient had blood pressure 110/70 mmHg, oxygen saturation 0.98, and heart rate 70-80 beats/min. Auscultation revealed the patient had coarse breath sounds in both lungs and slight moist rales were heard in her right lower lung. On postoperative day 5, the patient′s condition was stable and her wound healed well and then she was discharged.