他克莫司致不动性缄默症或硬膜外导管移位1例报告。

IF 0.5 A&A Practice Pub Date : 2023-07-01 DOI:10.1213/XAA.0000000000001699

Patrick T Hussey, Josiah Sowell, Hanna Hussey, Matthew M Townsley

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引用次数: 0

摘要

新发全身瘫痪的根本原因的鉴别诊断是具有挑战性和不令人满意的。动态缄默症是他克莫司的一种罕见的副作用，患者会变得麻木、沉默，并失去随意肌肉运动。硬膜外蛛网膜下腔迁移可出现类似症状。麻醉后迟发性出现/麻痹包括手术药物残留、中风以及他克莫司诱发的不动性缄默症和胸椎硬膜外移位等常见原因。我们报告了一例新发全身麻痹，出现在术后第1天，患者在双肺移植后开始使用他克莫司并放置胸硬膜外导管。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Tacrolimus-Induced Akinetic Mutism or Epidural Catheter Migration: A Case Report.

Differential diagnosis of the underlying cause of new-onset total body paralysis can be challenging and unsatisfying. In akinetic mutism, a rare side effect of tacrolimus, patients become apathetic, mute, and lose voluntary muscle movement. Epidural subarachnoid migration can present with similar symptoms. Delayed emergence/paralysis after anesthesia can include the common culprits of residual operative medications, stroke, as well as tacrolimus-induced akinetic mutism and thoracic epidural migration. We present a case of new-onset total body paralysis, presenting on postoperative day 1 following a double-lung transplant in a patient started on tacrolimus with a thoracic epidural catheter in place.

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A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.