Mauritz W, Hackl W, Winkler M, Sporn P, Steinbereithner K
Ludwig Boltzmann Institute of Experimental Anesthesiology and Research in Intensive care, Vienna, Austria.
Acta Anaesthesiol Belg. 1990;41(2):87-94.
The intra- and postoperative course of 30 general and 3 regional anesthetics in 27 MH-carriers verified by in vitro contracture tests is reported. None of the patients received dantrolene prophylactically. Disposable tubings were used for ventilation, vaporizers and soda lime were removed. ECG, esophageal temperature, blood pressure, oxygen saturation, and end tidal pCO2 were monitored. Minor tranquilizers were offered for premedication. Fentanyl, thiopentone, nitrous oxide, non depolarizing relaxants, neuromuscular antagonists and naloxone were used. In three patients, surgery was performed during epidural or spinal anesthesia with the use of amide local anesthetics. Neither MH-related changes in perioperative heart rates, body temperatures, and CK levels nor any other symptoms of MH were observed in any patient. The anesthetic techniques used seem to be safe and reliable; the anesthetic management of known MHS patients is discussed in detail.
报告了27例经体外挛缩试验证实为恶性高热（MH）携带者的30例全身麻醉和3例区域麻醉的术中和术后过程。所有患者均未预防性使用丹曲林。使用一次性管道进行通气，移除蒸发器和碱石灰。监测心电图、食管温度、血压、氧饱和度和呼气末二氧化碳分压。术前给予小剂量镇静剂。使用了芬太尼、硫喷妥钠、氧化亚氮、非去极化肌松药、神经肌肉拮抗剂和纳洛酮。3例患者在硬膜外或脊髓麻醉下使用酰胺类局部麻醉药进行手术。未观察到任何患者出现与MH相关的围手术期心率、体温和肌酸激酶水平变化，也未出现任何其他MH症状。所采用的麻醉技术似乎安全可靠；详细讨论了已知MH易感性患者的麻醉管理。
