Hypertensive crisis and paroxysmal supraventricular tachycardia are serious adverse reactions that can lead to fatal consequences. We reported a 28-year-old woman who underwent emergency cesarean section of her first fetus due to pelvic outlet stenosis and had a hypertensive crisis, merging with paroxysmal supraventricular tachycardia after dezocine was administrated during the procedure. Her symptoms returned to normal after esmolol and urapidil were administrated. In order to rule out hypertension crisis caused by other diseases, the anesthesiologist immediately accessed the thyroid function, myocardial enzymes, catecholamines, and arterial blood gas analysis of the patient. No obvious abnormality was found in all the test results. We infer the conclusion that the symptoms of this patient during the operation were most likely related to dezocine administration. This case highlights the need to pay attention to possible malignant adverse reactions while using dezocine during cesarean section, and we recommend the immediate use of α-receptor blockers and/or β-receptor blockers in situations like to avoid serious complications caused by supraventricular tachycardia.
Background: Dezocine is a novel opioid receptor-antagonistic analgesic, which is widely used in clinic work. However, its usage in cesarean section is rare.Case presentation: A 28-year-old woman of 38 weeks' gestation (163cm, 79kg) underwent emergency cesarean section because of pelvic outlet stenosis in November 2021. There was no history of preeclampsia, anticoagulation, or hemorrhagic diathesis. The most recent electrocardiogram (ECG) during pregnancy was sinus tachycardia, and the heart rate (HR) was 108 beats/min. After the accomplishment of spinal anesthesia, the cesarean section started smoothly. After the fetus was delivered, the patient complained of pain when suturing the skin. The anesthesiologist gave her dezocine 5mg and the parturient presented with hypertensive crisis merging paroxysmal supraventricular tachycardia (PSVT). The fastest HR was 178 beats/min and the highest blood pressure (BP) was 190/128mmHg. After Esmolol 20mg and Urapidil 12.5mg were administrated, her HR and BP returned normal range 3min later. After observation, the patient returned to the ward one hour later and left hospital after 5 days. The patient denied the history of PSVT and hyperthyroidism.Conclusion: Nowadays,dizocine has been widely used in the area of postoperative analgesia. However, its usage is rare in obstetrics and gynecology. The malignant adverse reactions of dizocine needs to be highly vigilant.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.