Wruck G, Tryba M
Zentrum für Anaesthesiologie, Oststadtkrankenhaus, Medizinische Hochschule Hannover.
Anaesthesist. 1989 May;38(5):255-8.
An emergency laparotomy was performed in a 31-year-old female (body wt 48 kg) with known myotonic dystrophy. Premedication with dantrolene (1 mg/kg i.v.) was used to prevent a myotonic response. Muscle relaxation was monitored electromyographically. Following induction with fentanyl (0.3 mg) and thiopental (200 mg), muscle relaxation was achieved with 2 mg vecuronium titrated for about 3 min until the T1-response was reduced to 10%. The recovery time was normal. A repetitive dose of 0.5 mg vecuronium was necessary after 20 min, when the T1 reached 60%. Extubation and the early postoperative period were uneventful. Because of the unknown predisposition of our patient for the development of malignant hyperthermia, anesthesia was performed with trigger-free anesthetics.
对一名已知患有强直性肌营养不良的31岁女性(体重48千克)进行了急诊剖腹手术。术前使用丹曲林(1毫克/千克静脉注射)预防肌强直反应。通过肌电图监测肌肉松弛情况。在使用芬太尼(0.3毫克)和硫喷妥钠(200毫克)诱导后,用2毫克维库溴铵滴定约3分钟直至T1反应降至10%,从而实现肌肉松弛。恢复时间正常。20分钟后,当T1达到60%时,需要重复给予0.5毫克维库溴铵。拔管和术后早期过程顺利。由于我们的患者发生恶性高热的易感性未知,因此使用无触发麻醉剂进行麻醉。