使用含有芬太尼的可卡因引起双侧臂丛病后发生横纹肌溶解。

Lauren Dobrie, Talin Handa, Igor Sirotkin, Angel Cruz, Demetrios Konstas, Esther Baldinger
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引用次数: 2

摘要

背景:横纹肌溶解是由肌肉过度使用、外伤、长时间固定、药物或毒素引起的。随着横纹肌溶解的进展,肿胀和水肿会压迫周围的组织。这种现象作为药物使用的后遗症很少有报道。病例介绍:我们报告了一位68岁男性患者,在使用含有芬太尼的快克可卡因后出现横纹肌溶解。患者双侧力量0/5,双侧上肢反射缺失。感觉明显下降,因为他感觉不到温度、针刺感或一般的触觉。肌酸磷酸激酶水平升高至21,292 IU/L。磁共振成像显示双侧下颈部有异常信号。我们推测,肌肉水肿导致双侧胸廓出口部分狭窄,并对穿过的臂丛产生相应的肿块效应。结论:这是文献中报道的第七例由阿片类药物使用引起的横纹肌溶解继发的臂丛病。前瞻性研究应该检查这种情况的治疗方法。
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Rhabdomyolysis Occurring After Use of Cocaine Contaminated With Fentanyl Causing Bilateral Brachial Plexopathy.

Background: Rhabdomyolysis is caused by muscle overuse, trauma, prolonged immobilization, drugs, or toxins. As rhabdomyolysis progresses, swelling and edema can compress surrounding structures. Few cases of the phenomenon occurring as a sequela of substance use have been described.

Case presentation: We present a 68-year-old male patient with rhabdomyolysis following use of crack cocaine contaminated with fentanyl. The patient had 0/5 strength bilaterally and bilateral absent reflexes in the upper extremities. Sensation was markedly decreased, as he was unable to feel temperature, pinprick sensation, or general touch. Creatine phosphokinase level was elevated at 21,292 IU/L. On magnetic resonance imaging, there was abnormal signal in the lower neck bilaterally. It is presumed that muscular edema resulted in partial narrowing of the thoracic outlet bilaterally with corresponding mass effect on the traversing brachial plexus.

Conclusions: This is the seventh case of brachial plexopathy secondary to rhabdomyolysis precipitated by opioid use that has been reported in the literature. Prospective studies should examine treatment for this condition.

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