双氯芬酸钠利多卡因注射液诱发严重低血糖致死亡

Death due to severe hypoglycemia caused by diclofenac sodium and lidocaine injection

1例53岁男性患者因腹痛给予双氯芬酸钠利多卡因注射液2 ml肌内注射。用药1 h后患者出现上腹部不适,胸闷气急,大汗,口唇微绀。立即给予吸氧。心电监护示血压105/60 mmHg(1 mmHg=0.133 kPa),心率125次/min,血氧饱和度0.75,末梢血糖测不出。立即予补充葡萄糖及激素治疗。约30 min后患者出现意识不清,大动脉无搏动,心搏与呼吸停止,立即予心肺复苏及其他救治措施。但患者一直未恢复自主心律与呼吸,宣布死亡。考虑患者的严重低血糖与双氯芬酸钠利多卡因有关。

A 53⁃year⁃old male patient received intramuscular injection of diclofenac sodium and lidocaine injection 2 ml for abdominal pain.After one hour of medication,the patient developed upper abdominal discomfort,chest tightness,shortness of breath,sweating,and slight cyanosis of lips.Oxygen inha⁃lation was given immediately.Electrocardiogram monitoring showed blood pressure 105/60 mmHg,heart rate 125 beats/min,and blood oxygen saturation 0.75.His peripheral blood glucose could not be detected.Glucose supplement and hormone therapy were given immediately.About 30 minutes later,the patient developed unconsciousness,no pulsation of the main artery,and cardiac and respiratory arrest.Cardiopul⁃monary resuscitation and other treatment measures were given immediately.However,the patient did not return to spontaneous heartbeat and breathing and was declared dead.It was considered that the patient′s severe hypoglycemia might be related to diclofenac sodium and lidocaine.