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首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Central Anticholinergic Syndrome Induced By Cyclopentolate Eye Drops In A 4 Year Old Child
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Central Anticholinergic Syndrome Induced By Cyclopentolate Eye Drops In A 4 Year Old Child

机译：环戊酸酯滴眼液引起的4岁儿童中枢抗胆碱能综合症

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摘要

Central anticholinergic syndrome (CAS) is a clinical entity which shows central and peripheral effects produced by over dosage or abnormal reaction to clinical dosage of anticholinergic drugs. Anxiety, delirium, disorientation, hallucinations, seizures, tachycardia, hyperpyrexia, mydriasis, vasodilatation, gastric and urinary retention can be observed during CAS. In this syndrome, it is common decreased salivary, sweating, bronchial, and nasopharyngeal secretions. Cyclopentolate is an anticholinergic drug and it was used in cycloplegic eye examinations for mydriasis.A 4 year-old girl presented to ophthalmology clinic for refraction problems. Three drops of cyclopentolate 1% for each eye was used four times at 5-min intervals to dilate the pupil. Thirty minutes after drop instillation, she started to experience drowsiness, agitation, hallucinations, jerkily moving all extremities and making frequent high-pitched cries. She admitted to intensive care unit (ICU) diagnosed with CAS. After intravenous bolus (0.1 mg/kg) and infusion (0.05-0.4/mg/kg/h) of midazolam, the symptoms including agitation, hallucinations, and high-pitched crying of the patient was controlled. Six hours after starting therapy in the ICU, the patient was fully recovered and discharged at 10th h after admission. Cyclopentolate eye drops can be absorbed to capillary circulation and reached to brain via deep cerebral veins and cavernous sinuses therefore, it may cause CAS.
机译：中枢抗胆碱能综合症（CAS）是一种临床实体，显示出抗胆碱能药物的过量或对临床剂量的异常反应产生的中枢和外周作用。在CAS期间可观察到焦虑，del妄，迷失方向，幻觉，癫痫发作，心动过速，高热，散瞳，血管舒张，胃和尿retention留。在这种综合征中，唾液，出汗，支气管和鼻咽分泌物减少是常见的。环戊酸酯是一种抗胆碱能药物，用于对瞳孔散瞳进行睫状肌麻痹检查。一名4岁女孩因眼科屈光问题被送往眼科诊所。每只眼睛三滴1％的环戊酸酯滴眼液，每5分钟间隔四次，以扩张瞳孔。滴注三十分钟后，她开始出现困倦，躁动，幻觉，四肢抽动和频繁的高声哭泣。她进入诊断为CAS的重症监护病房（ICU）。静脉推注（0.1 mg / kg）和输注（0.05-0.4 / mg / kg / h）咪达唑仑后，可控制患者的症状，包括躁动，幻觉和剧烈的哭声。在ICU中开始治疗后六小时，患者已完全康复，入院后第10 h出院。环戊酸酯滴眼液可被毛细血管循环吸收并通过深部脑静脉和海绵窦到达大脑，因此可能引起CAS。

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