Flick Randall P, Gleich Stephen J, Herr Molly M H, Wedel Denise J
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Paediatr Anaesth. 2007 Jan;17(1):22-7. doi: 10.1111/j.1460-9592.2006.02105.x.
It is assumed that those children with known or suspected neuromuscular disorders (NMD) are at increased risk for malignant hyperthermia (MH). Despite the lack of conclusive data, most of these children are managed with a nontriggering anesthetic. This study examined the risk of MH in children exposed to a triggering anesthetic while undergoing muscle biopsy for suspected NMD.
Between 1992 and 2005, the medical records of 351 children under 21 years of age were identified as having undergone muscle biopsy for suspected NMD. Of these, only 274 received a volatile anesthetic agent or succinylcholine and were included for study. Records were examined for evidence of MH or rhabdomyolysis.
No patient exhibited signs or symptoms suggestive of MH. One patient was found, by muscle biopsy, to have evidence of rhabdomyolysis prior to exposure to a volatile anesthetic. Of 274 patients, only three received succinylcholine. None developed MH or rhabdomyolysis. The estimated risk of a patient with suspected NMD developing MH as a result of exposure to volatile anesthetic agents during muscle biopsy is 1.09% or less.
The estimated risk of MH or rhabdomyolysis is 1.09% or less in a diverse population of children with suspected NMD.
据推测，那些已知或疑似患有神经肌肉疾病（NMD）的儿童发生恶性高热（MH）的风险增加。尽管缺乏确凿数据，但这些儿童中的大多数在麻醉时采用非触发麻醉管理。本研究调查了疑似NMD的儿童在接受肌肉活检时接触触发麻醉剂后发生MH的风险。
在1992年至2005年期间，351名21岁以下儿童的病历被确定为因疑似NMD接受了肌肉活检。其中，只有274名接受了挥发性麻醉剂或琥珀酰胆碱，并被纳入研究。检查记录以寻找MH或横纹肌溶解的证据。
没有患者表现出提示MH的体征或症状。通过肌肉活检发现，一名患者在接触挥发性麻醉剂之前有横纹肌溶解的证据。在274名患者中，只有3名接受了琥珀酰胆碱。没有人发生MH或横纹肌溶解。疑似NMD的患者在肌肉活检期间因接触挥发性麻醉剂而发生MH的估计风险为1.09%或更低。
在不同的疑似NMD儿童群体中，MH或横纹肌溶解的估计风险为1.09%或更低。
Zotero 插件