Anesthetic poisoning

Introduction Local anesthetics mainly inhibit the central nervous system, but when poisoned, it can cause central nervous system excitation, cardiac inhibition, vasodilation, etc., and thus related symptoms. In recent years, when pregnant women give birth, they often use some kind of local anesthetic analgesia. These drugs can be absorbed by the mother to pass the placenta and cause neonatal poisoning. If the cause is used for fistula block or peri-cervical anesthesia, careless Injecting local anesthetics into the fetus can cause serious poisoning symptoms in newborn babies. The liver and kidney development of newborn babies are not yet mature, and the metabolism and excretion functions of these drugs are very poor.

Cause

Local anesthetics include procaine, cocaine, lidocaine, marcaine, carbocaine, prilocaine, etc. The nervous system acts as an inhibitor, but when it is poisoned, it can cause central nervous system excitation, cardiac inhibition, vasodilation, etc., and symptoms appear. Local anesthetic drugs are intruding into the blood vessels or the amount of local anesthetic absorbed into the blood per unit time is too large, or the patient's systemic nutritional regulation is poor, liver and kidney dysfunction, causing the local anesthetic concentration in the blood to cause toxicity, mainly as the central nervous system. Nervous system toxicity and cardiovascular dysfunction.

an examination

Related inspection

Electrocardiogram blood routine

When local anesthetics are poisoned, the child develops dizziness, vomiting, convulsions, convulsions, coma, shock, etc., and even death. Promethazine poisoning can cause methemoglobinemia.

The main clinical manifestations of local anesthetic poisoning in newborn babies are respiratory weakness or asphyxia, bradycardia, and decreased muscle tone; common convulsions, dilated pupils, slow or absent response to light, and disappearance of eye-head reflexes. The above symptoms usually appear within 6 to 12 hours after birth, and some newborns can occur immediately after birth. Most of the seizures are strong and straight, and a few are clonic-strength.

In addition, newborns with encephalopathy due to hypoxemia often have similar symptoms after 12 to 24 hours of birth. Therefore, if the mother has a history of injection of local anesthetic drugs, and the newborn has pupil dilation in the early postnatal period, the light reflection disappears, the eye-head reflex disappears, and the above signs still appear after resuscitation, which is highly suggestive of local anesthetic poisoning. . Sometimes, puncture marks are found on the scalp of the sick baby, and a small amount of liquid medicine can be sucked out in the part.

Differential diagnosis

Ether poisoning: Ether refined products are mainly used for surgical anesthesia in the clinic and are an ancient, safe and effective general anesthetic. Its acute poisoning is mainly caused by excessive inhalation. Clinical manifestations of clinically seen a large number of ether inhalation caused by paralysis, are not seriously treated, do not find that the breathing has a shallow speed, shallow slow, sobbing or sighing changes, did not pay attention to exhalation and inhalation appeared Frequent pauses and the arrival of rhythm and other signs of respiratory arrest, resulting in high concentrations of time. The ability to detect and take effective measures in a timely manner can have serious consequences.

Thiopenol poisoning: thiopental sodium, also known as sodium pentothiopyrazine, Panpe, is a short-acting barbiturate type of barnamine, clinically used for short-term surgery, usually used Its 1%-25% solution is used in a single dose of 0.5 g and the amount is 1.0 g/time. Sodium thiopentate is strongly alkaline, and intravenous injection of the drug solution leaks out of the blood vessel or the outer skin, which is easy to organize necrosis. Furthermore, intravenous injection should be slow to avoid central inhibition and apnea. For severe acidosis, severe anemia, heart disease, hypokalemia, shock, and bronchial asthma cause apnea. For severe acidosis, severe anemia, heart disease, hypotension, shock, bronchial asthma should be used with caution or avoidance, so as not to cause poisoning.

Cocaine poisoning: cocaine, also known as cocaine. The drug was originally proposed from the leaves of coca, an alkaloid, which was later synthesized and is an ester of amino acids and aromatic acids. Clinically, it mainly acts on topical anesthetics for ocular and nasopharyngeal surgery. In addition, procaine, dicaine, lidocaine and cacaine are present, and their chemical structures are similar to cocaine. When local anesthetics are poisoned, the child develops dizziness, vomiting, convulsions, convulsions, coma, shock, etc., and even death. Promethazine poisoning can cause methemoglobinemia.

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