顺阿曲库铵致围手术期患者过敏性休克1例

打开文本图片集

【中图分类号】 R971+.8 【文献标识码】A

【Abstract】A 42-year-old male patient developed mild allergic symptoms after the use of cisatracurium besylate in laparoscopic left renal tumor resection， which was relieved by symptomatic treatment. When the drug was added again intraoperatively， the patient's blood pressure decreased sharply from 12/71mmHg to 5/3mmHg ，and the airway resistance increased from 16cmH2O to 38cmH2O， and the patient developed typical signs of anaphylactic shock.After immediate intravenous injection of epinephrine，calcium chloride and other drugs，the patient's blood pressure rose to 95/57mmHg ，airway resistance decreased to 2cmH2O3 ，and vital signs tended to be stable.The Naranjo's Assessment Scale was used to evaluate and analyze the correlation of suspected drugs. The score was 9 points， indicating that the association between anaphylactic shock and cisatracurium besylate inthis patient was judged to be"definitely related".This article suggests that cisatracurium besylate carries an allergic risk and should be used with caution，and the monitoring of vital signs andalergic reactions should be strengthened for early identificationand timelytreatment to ensure thesafetyof patients during the perioperative period.

【Keywords】Cisatracurium besylate; Anaphylactic shock; Adverse drug reactions

顺阿曲库铵是临床麻醉中常用的神经肌肉阻滞剂，作为阿曲库铵的立体异构体，其神经肌肉阻滞效力是后者的4倍[1]，且不经过肝肾代谢，不引起组胺释放，目前是肝肾功能损伤患者、重症患者首选的肌松药[2-4]，临床应用前景广阔。（剩余6904字）