顺式阿曲库铵过敏致一过性肺动脉高压  

Transient pulmonary hypertension secondary to anaphylaxis due to cisatracurium

作　　者：曾鹤琳 廖志敏 Zeng Helin;Liao Zhimin(Department of Anaesthesiology,Key Laboratory of Birth Defects and Related Diseases of Women and Children,West China Second Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院麻醉科/出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《药物不良反应杂志》2021年第9期502-504,共3页Adverse Drug Reactions Journal

摘　　要：1例49岁女性患者因双侧输卵管脓肿合并急性肾衰竭在全身麻醉下行腹腔镜探查术。麻醉诱导期间,先后使用咪达唑仑、舒芬太尼、顺式阿曲库铵和丙泊酚,发生严重低氧血症,脉搏血氧饱和度最低0.57。超声心动图检查显示右心增大,三尖瓣反流及肺动脉高压(估算肺动脉压62 mmHg,1 mmHg=0.133 kPa)。经气管插管、机械通气辅助呼吸、氢化可的松和罂粟碱治疗,低氧血症得以纠正,手术顺利完成。术后第2天复查超声心动图,肺动脉压恢复正常。术后第9天经针刺皮试,确定患者对顺式阿曲库铵过敏。考虑本例患者的一过性肺动脉高压为该药过敏反应引起肺血管痉挛所致。A 49-year-old female patient underwent laparoscopic exploration under general anesthesia due to bilateral tubal abscess complicated with acute renal failure.During anesthesia induction,midazolam,sufentanil,cisatracurium,and propofol were used successively,resulting in severe hypoxemia with the lowest pulse oxygen saturation of 0.57.Echocardiography showed right heart enlargement,tricuspid regurgitation,and pulmonary hypertension(estimated pulmonary artery pressure 62 mmHg).Through tracheal intubation,assisted breathing with mechanical ventilation,and treatments with hydrocortisone and papaverine,the hypoxemia was corrected and the operation was completed successfully.Echocardiography showed the pulmonary artery pressure returned to normal on the 2nd day after operation.The patient was determined to be hypersensitive to cisatracurium by a needle skin test on the 9th postoperative day.It was considered that the transient pulmonary hypertension in the patient was caused by pulmonary vasospasm due to allergic reaction to the drug.

关 键 词：阿曲库铵 低氧 高血压 肺性 药物相关副作用和不良反应 

分 类 号：R969.3[医药卫生—药理学]