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[第六次使用挥发性麻醉剂进行全身麻醉期间发生的暴发性恶性高热]

[Fulminant malignant hyperthermia during the 6th general anesthesia using volatile anesthetics].

作者信息

Striebel H W, Lechner J, Wiegand C, Hartung E

机构信息

Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Steglitz, Freie Universität Berlin.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 1991 Dec;26(8):475-80. doi: 10.1055/s-2007-1000620.

Abstract

We report on the fulminant crisis of malignant hyperthermia occurring in a 30-year-old female during kidney transplantation. In the past, she had been anaesthetised repeatedly without complications. Anaesthesia was induced with thiopental and vecuronium and continued with isoflurane/N2O/O2. After an initially normal course of anaesthesia, the patient developed symptoms of a fulminant malignant hyperthermia (MH) including excessive increase in end expiratory CO2, hyperkalaemia, tachycardia and hyperpyrexia. The patient was saved by the timely administration of dantrolene. A surgical revision required the next day because of bleeding was done under dantrolene cover and took an uncomplicated course. The patient was extubated 7.5 hours after the second intervention and transferred to a normal ward after 4 days. A subsequently performed in vitro contracture test clearly revealed susceptibility to malignant hyperthermia.

摘要

我们报告了一例30岁女性在肾移植过程中发生的恶性高热暴发性危机。过去,她曾多次接受麻醉且无并发症。麻醉诱导使用硫喷妥钠和维库溴铵,并持续使用异氟烷/氧化亚氮/氧气。在最初麻醉过程正常后,患者出现了恶性高热(MH)的暴发性症状,包括呼气末二氧化碳过度升高、高钾血症、心动过速和高热。通过及时给予丹曲林,患者得以挽救。由于出血,次日在丹曲林保护下进行了手术翻修,过程顺利。第二次干预7.5小时后患者拔管,4天后转入普通病房。随后进行的体外挛缩试验明确显示对恶性高热易感。

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