Nikaido Yuki, Murao Kohei, Ikeda Sakahiro, Sakamoto Sachiyo, Uchiyama Yuka, Shingu Koh
Department of Anesthesiology, Kansai Medical University, Moriguchi 570-8506.
Masui. 2003 Feb;52(2):162-4.
We report anesthetic management of a patient suspected of malignant hyperthermia with difficult tracheal intubation. A 64-year-old man was scheduled for a fixation of humerus bone fractures in prone position. He had a history of difficult tracheal intubation due to masseter spasm, and his niece was suspected to be malignant hyperthermia. Anesthesia was induced with propofol using a target controlled infusion. No muscle relaxant was given and spontaneous breathing was maintained. Trials for tracheal intubation failed whenever using a standard laryngoscope, a bronchofiberscope, a laryngeal mask airway or an intubating laryngeal mask airway. Resecting the epiglottic elevating bar of an intubating laryngeal mask airway enabled fiberoptic tracheal intubation. No symptom suggesting malignant hyperthermia developed.
我们报告了一例疑似恶性高热且气管插管困难患者的麻醉管理情况。一名64岁男性计划在俯卧位下行肱骨骨折内固定术。他有因咬肌痉挛导致气管插管困难的病史，且其侄女疑似患有恶性高热。采用靶控输注丙泊酚诱导麻醉。未给予肌肉松弛剂并维持自主呼吸。无论使用标准喉镜、纤维支气管镜、喉罩气道还是插管型喉罩气道，气管插管尝试均失败。切除插管型喉罩气道的会厌提升杆后成功实施了纤维光导气管插管。未出现提示恶性高热的症状。
