的卡因引起房室传导阻滞一例
JOURNAL OF CLINICAL INTERNAL MEDICINE(1999)
Abstract
患者,男性,22岁.因右眼视力下降2年以外伤性白内障(右 )收入院,准备行白内障现代囊外摘除术.既往无心脏病史,入院体检无异常,第3天双眼测眼压,应用0.5%的卡因滴眼,每眼各滴2滴,测毕后约15分钟行术前心电图检查,发现心脏Ⅰ°心室传导阻滞,P-R为0.34 s,当时病人稍感胸闷,无其它不适,因患者于一年前在外院心电图检查报道正常,故8小时后复查心电图,Ⅰ°房室传导阻滞消失,P-R为0.18 s,为了证实房室传导阻滞为的卡因引起,于第5天在心电图监护下再次应用的卡因滴眼,剂量同前,滴眼前P- R为0.18 s,滴眼后P-R逐渐延长,约在15分钟P-R最长达0.32 s,此后P-R又逐渐缩短,1小时后,P-R恢复至0.18 s,心电图大致正常,在此期间,病人又自觉胸闷,逐渐自行缓解.因患者对手术有恐惧感,未行手术.
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