Maeda Tsuyoshi, Enomoto Tatsuya, Kamiyama Yoichiro, Inada Eiichi
Department of Anesthesiology, Juntendo University Urayasu Hospital, Urayasu 279-0021.
Masui. 2011 Dec;60(12):1384-6.
A 62-year-old woman was treated for schizophrenia for 40 years. When the symptoms had deteriorated and new medications had to be added, CPK rose and she malignant syndrome was suspected. The electroconvulsive therapy (ECT) was proposed because of no improvement of the symptoms. We employed rocuronium bromide instead of suxamethonium considering malignant syndrome. The maintenance of anesthesia was necessary, because the duration of rocuronium bromide is longer than that of suxamethonium chloride. Anesthesia was induced and maintained using target controlled infusion (TCI) of propofol. After ECT was performed, sugammadex sodium 4 mg . kg-1 was administered at 2 post-tetanic counts (PTC) and the patient could come out the operating room safely and speedy. ECT using rocuronium bromide and sugammadex sodium can be performed safely and speedily, when suxamethonium chloride cannot be used.
一名62岁女性患精神分裂症40年。症状恶化且必须添加新药物时，肌酸磷酸激酶（CPK）升高，怀疑发生恶性综合征。因症状无改善，建议采用电休克治疗（ECT）。考虑到恶性综合征，我们使用罗库溴铵而非琥珀酰胆碱。由于罗库溴铵的作用持续时间长于氯化琥珀酰胆碱，因此需要维持麻醉。采用丙泊酚靶控输注（TCI）诱导并维持麻醉。ECT治疗后，在强直后计数（PTC）为2时给予4 mg·kg-1的 sugammadex 钠，患者能够安全、迅速地离开手术室。当不能使用氯化琥珀酰胆碱时，使用罗库溴铵和sugammadex钠进行ECT可安全、迅速地进行。
