Wilbanks Bryan A, Wakim Judith, Daicoff Barbara, Monterde Scott
Huntsville Hospital, Alabama, USA.
AANA J. 2005 Dec;73(6):437-41.
Muscle relaxants are routinely administered during anesthesia. The residual effects of nondepolarizing muscle relaxants must be reversed by the anesthesia provider prior to extubation of the trachea to ensure that patients can safely protect their own airways and maintain adequate ventilation. Many factors can potentiate the effects of muscle relaxants, and each of these factors must be taken into consideration when postoperative muscle weakness is encountered. Only after the cause of residual neuromuscular weakness is discerned can the appropriate treatment be determined. This article describes the anesthetic management of a patient who experienced postoperative residual muscle weakness secondary to unsuspected hyperkalemia. A discussion of potassium's role in membrane excitability and factors that must be considered in the differential diagnosis of residual neuromuscular weakness is included.
麻醉期间通常会使用肌肉松弛剂。在气管拔管前，麻醉医生必须逆转非去极化肌肉松弛剂的残余作用，以确保患者能够安全地保护自己的气道并维持足够的通气。许多因素会增强肌肉松弛剂的作用，当出现术后肌肉无力时，必须考虑到这些因素中的每一个。只有在辨别出残余神经肌肉无力的原因后，才能确定适当的治疗方法。本文描述了一名因意外高钾血症继发术后残余肌肉无力患者的麻醉管理。文中还讨论了钾在膜兴奋性中的作用以及在残余神经肌肉无力鉴别诊断中必须考虑的因素。
