左旋布比卡因联合股坐骨神经阻滞治疗Brugada综合征1例

Diego Tavoletti, E. Rosanò, E. Cerutti, L. Pecora
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摘要

Brugada综合征是一种罕见的心律失常,与心室颤动和心源性猝死相关。Brugada综合征患者的一般建议集中在避免迷走神经张力增加和沉淀剂,如电解质紊乱、低温/高热和药物。许多病例报告描述了Brugada综合征患者的麻醉管理,但仍不清楚哪种麻醉是最安全的。局部麻醉可能有理论上的致心律失常风险,但目前没有明确的证据,其风险仍存在争议。外周神经阻滞避免了自主神经系统的改变,这是其他麻醉技术所发生的,并且与神经轴麻醉相比,它与局部麻醉剂的血浆浓度水平较低有关。病例报告:我们报告了一例38岁的Brugada综合征患者,他接受了紧急骨科手术,使用左布比卡因联合股神经和坐骨神经阻滞,没有任何并发症。结论:左旋布比卡因周围神经阻滞治疗Brugada综合征具有良好的镇痛效果、血流动力学和心脏稳定性。关键词:Brugada综合征,麻醉,左旋布比卡因,周围神经阻滞,区域麻醉
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combined femoral and sciatic nerve block with Levobupivacaine in Brugada syndrome patient: A case report
Introduction: Brugada syndrome is a rare arrhythmic disorder associated to ventricular fibrillation and sudden cardiac death. General recommendations in Brugada syndrome patient are focused on avoiding increases in vagal tone and precipitating agents such as electrolyte disorders, hypo/hyperthermia and drugs. Anesthetic management in Brugada syndrome patient has been described in many case reports, however it is still unknown which anesthesia is the safest. Local anesthetic may have a theoretical arrhythmogenic risk, but currently there is no clear evidence and their risk is still debated. Peripheral nerve block avoids autonomic nervous system changes that occur with other anesthetic techniques and it is associated to a lower level in the plasma concentration of the local anesthetic compared with neuraxial anesthesia. Case Report: We report a case of a 38-year-old man patient with Brugada syndrome who underwent urgent orthopedic surgery which was managed with a combined femoral and sciatic nerve blocks using levobupivacaine without any complications. Conclusions: Peripheral nerve block with levobupivacaine provided good analgesia, hemodynamic and cardiac stability in Brugada syndrome patient. Keywords: Brugada syndrome, Anesthesia, Levobupivacaine, Peripheral nerve block, Regional anesthesia
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