<原著>局所麻酔薬ショックとその治療

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As the use of local anesthetic techniques in clinical medicine increases, the potential systemic reactions such as systemic toxicity and anaphylaxis or anaphylactoid reaction take an added importance. The underlying mechanisms of these two kinds of "reactions" are essentially different. These reactions are both very rapid in the clinical course and the fatal outcome is not a rare phenomenon. The mechanism of anaphylaxis or anaphylactoid reaction is related to IgE-mediated release of chemical mediators which precipitate the manifestations of acute respiratory failure and cardiovascular collapse. The immediate treatment and drug of choice is epinephrine. Subsequent therapy is based on the clinical manifestations. The mechanism of systemic toxicity of local anesthetics is derived from the pharmacological drug actions on the CNS and cardio-vascular system. The degree of symptoms are dose-related. The CNS is more prone to the toxicity. The systemic toxicity is usually believed due to a rapid inadvertent intravenous injection, administration into a highly vascular anatomical site, or the extravascular administration of excessive dose. Prevention is achieved by the technically careful administration of proper dose. The proper treatment of systemic toxicity include the maintenances of oxygenation and the cessation of convulsions. The drug of choice is diazepam. Prompt recognition and differential diag-nosis are essential for the proper treatment of these reactions.
近畿大学の論文
1979-09-25

<原著>局所麻酔薬ショックとその治療

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