Carlos Ricardo Vieira, Torres Marcelo Luis Abramides, de Boer Hans Donald
Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, SP, Brasil.
Martini General Hospital Groningen, Department of Anesthesiology and Pain Medicine, Groningen, Holanda.
Braz J Anesthesiol. 2018 Jul-Aug;68(4):416-420. doi: 10.1016/j.bjan.2017.10.008. Epub 2018 Jan 6.
Heart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block. Several reports described that cholinesterase inhibitors drugs, like neostigmine, may produce a dose-dependent life-threatening bradycardia in heart transplant recipients while other publication described the safe use of neostigmine. Reversal of neuromuscular block with sugammadex is another possibility, but limited data exists in literature. We describe five cases in which successful reversal of neuromuscular block was performed with sugammadex in heart transplant pediatric recipients without sequale and discuss the reversal of neuromuscular block in this patient population.
心脏移植是治疗终末期心脏功能障碍的常见手术。因此，这些患者群体在移植后也会更频繁地接受其他更常见的外科手术。麻醉医生在评估这些患者时应予以关注，尤其是与心脏移植病史患者相关的一些特定问题，如神经肌肉阻滞的逆转。几份报告描述，胆碱酯酶抑制剂药物，如新斯的明，可能在心脏移植受者中产生剂量依赖性的危及生命的心动过缓，而其他文献描述了新斯的明的安全使用。使用舒更葡糖逆转神经肌肉阻滞是另一种可能性，但文献中的数据有限。我们描述了5例在小儿心脏移植受者中使用舒更葡糖成功逆转神经肌肉阻滞且无后遗症的病例，并讨论了该患者群体中神经肌肉阻滞的逆转情况。
