利多卡因过敏患者的硬膜外阵痛:一个病例系列。

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2021-02-16 eCollection Date: 2021-01-01 DOI:10.2147/LRA.S253087
Akshatha Kamath, Vikas Raghove, Allison Kalstein, Joel Yarmush
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引用次数: 4

摘要

持续硬膜外麻醉被认为是分娩过程中缓解疼痛的最佳方式,局部麻醉过敏并不常见,但如果患者因布比卡因或利多卡因的交叉反应而对布比卡因或利多卡因过敏,那么分娩镇痛的管理就变得非常具有挑战性。考虑到在试验剂量下发生严重过敏反应所涉及的风险,排除实际超敏反应的直接激发试验不被认为是可行的选择。静脉使用阿片类药物镇痛对母亲和婴儿都有有害影响,此外,由于其镇静特性,还会减少母亲参与分娩过程。我们报告了两例母亲有利多卡因过敏史的病例,因此使用氯普鲁卡因患者自控硬膜外镇痛(PCEA)进行分娩镇痛。
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Labor Epidural in a Patient Who is Allergic to Lidocaine: A Case Series.

Continuous epidural anesthesia is considered the best modality for pain relief during labor, local anesthetic allergy is an uncommon occurrence but if a patient has an allergy to bupivacaine or lidocaine owing to its cross-reactivity with bupivacaine then it becomes very challenging to manage labor analgesia. A direct challenge test to rule out actual hypersensitivity was not considered a viable option given the risks involved if a severe allergic reaction occurred with the test dose. Using IV opioid-based analgesia has harmful effects for both mother and the baby in addition to decreasing participation of mothers in the birthing process owing to its sedative properties. We report two cases where the mother had a history of lidocaine allergy, so labor analgesia was managed using chloroprocaine patient-controlled epidural analgesia (PCEA).

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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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