罗哌卡因颈丛神经阻滞致心律失常

患者,女性,52岁,因患右侧甲状腺占位性病变拟行右侧甲状腺部分切除术。术前血压140/83mmHg,HR90次/min,心电图正常,脉搏血氧饱和度(SpO2)0.96。用0.75%罗哌卡因与2%利多卡因1∶1混合液共20ml行双侧颈丛神经阻滞麻醉,注药后5min患者出现心悸、胸闷、憋气、精神紧张、兴奋多语等症状。心电监护显示:BP168/95mmHg,HR120次/min,频发室性期前收缩,偶呈二联律,SpO20.90。听诊两肺有哮鸣音,心律不齐。经给予咪达唑仑、利多卡因、地塞米松及供氧等处理后症状缓解。

Cardiac arrhythmia following administration of ropivacaine for cervical plexus block

A 52-year-old woman was scheduled to undergo right partial thyroidectomy for right thyroid occupying lesion.Preoperative electrocardiographic monitoring showed the following records:BP 140/83 mmHg,HR 90 beats/min,ECG normal,pulse oxygen saturation(SpO2)0.96.She received 20 ml of a mixed solution prepared with 0.75% ropivacaine solution and 2% lidocaine solution in a ratio of 1 to 1 for bilateral cervical plexus block.Five minutes after administration,the woman developed palpitation,chest distress,breath holding,mental stress,excitation and logorrhea.His BP was 168/95 mmHg,his HR was 120 beats/min with frequent premature ventricular contraction and occasional bigeming,and his SpO2 was 0.90.And the auscultation revealed wheezes in the lungs and arrhythmia.After receiving midazolam,lidocaine,dexamethasone,and oxygen,she recovered gradually.