小剂量氟哌利多致美容手术术中暂停或取消五例

Five cases of cosmetic surgery were suspended or cancelled by low-dose droperidol

美容手术以女性为主,女性也是术后恶心呕吐(postoperative nausea and vomiting,PONV)的高发人群;美容手术常用局部麻醉,但局麻阻滞不完善会加重患者的紧张焦虑,造成循环系统的剧烈波动,增加组织损伤和出血,影响术后康复及手术效果。因此需使用镇静镇痛药物辅助来达到抗焦虑、镇静、镇痛和防治PONV的作用。氟哌利多具有镇静、强效镇吐作用,小剂量氟哌利多(0.625 mg-1.25mg)预防PONV尤其是吗啡镇痛导致的PONV效果良好。但用药后发现个别患者出现不能解释的"极度紧张焦虑",致使手术暂停或终止。认真分析研究后确定是氟哌利多导致的静坐不能,经使用苯二氮卓类治疗后症状消失。

Women make up the major patients of cosmetic surgery and are also quite easy to experience postoperative nausea and vomiting(PONV).Local anesthesia mostly used in cosmetic surgery.However,imperfect local anesthesia will aggravate patient anxiety and result in wild fluctuation of circulatory system,causing more tissue damage and bleeding and affecting postoperative rehabilitation and operation outcomes.Therefore,it’s necessary to use sedation and analgesia medicines to relieve anxiety,relieve pain,calm the patient down and prevent PONV.Droperidol works effectively in calming patients down and preventing vomiting.Low-dose(0.625 mg-1.25mg)of droperidol works effectively in preventing PONV caused especially by morphine analgesia.Few patients,however,experienced inexplicable extremely anxiety following administration of droperidol and operation had to be suspended or canceled.Further studies found this resulted from akathisia caused by droperidol.The symptom disappeared after treatment with benzodiazepines.