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[一例易患恶性高热儿童的骨科手术麻醉:病例报告。]

[Anesthesia for orthopedic surgery in a child susceptible to malignant hyperthermia: case report.].

作者信息

Gomez Renato Santiago, Silva Yerkes Pereira, Peluso Cristiano Pereira

机构信息

Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais.

出版信息

Rev Bras Anestesiol. 2003 Feb;53(1):52-7.

Abstract

BACKGROUND AND OBJECTIVES

Malignant hyperthermia is an autosomal dominant myopathy triggered by inhalational anesthetics and neuromuscular blockers, such as halothane and succinylcholine, which causes temperature increases that may be fatal if not promptly treated. This report aimed at describing anesthesia in a child susceptible to malignant hyperthermia submitted to orthopedic surgery.

CASE REPORT

Female patient, 3 years of age, with congenital hip dislocation and susceptible to malignant hyperthermia, according to anesthetic history, who was submitted to corrective orthopedic surgery under general anesthesia with propofol and fentanyl, combined with lumbar epidural anesthesia. Temperature was closely monitored during surgery and in the postoperative period. Postoperative recovery was uneventful and patient was discharged five days later.

CONCLUSIONS

Combined regional and intravenous anesthesia for the surgical procedure proposed to a patient susceptible to malignant hyperthermia allowed a safe anesthetic approach.

摘要

背景与目的

恶性高热是一种常染色体显性遗传的肌病,由吸入性麻醉剂和神经肌肉阻滞剂(如氟烷和琥珀酰胆碱)引发,可导致体温升高,若不及时治疗可能致命。本报告旨在描述一名易患恶性高热的儿童接受骨科手术时的麻醉情况。

病例报告

一名3岁女性患者,有先天性髋关节脱位,根据麻醉史易患恶性高热,在丙泊酚和芬太尼全身麻醉联合腰段硬膜外麻醉下接受骨科矫正手术。手术期间及术后密切监测体温。术后恢复顺利,患者于五天后出院。

结论

对于易患恶性高热的患者,采用区域麻醉与静脉麻醉相结合的方式进行手术,可实现安全的麻醉方法。

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