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特发性脊柱侧弯手术全身麻醉期间发生恶性高热:一例报告。

Malignant hyperthermia during general anesthesia for a surgery of idiopathic scoliosis: A case report.

作者信息

Kim Han Young, Kim Young Ju

机构信息

Department of Anesthesiology and Pain Medicine, Eulji University Hospital, Daejeon, Korea.

出版信息

Korean J Anesthesiol. 2009 Nov;57(5):656-661. doi: 10.4097/kjae.2009.57.5.656.

Abstract

Malignant hyperthermia is a potentially fatal hypermetabolic syndrome characterized by skeletal muscle rigidity and hyperpyrexia. We had an 11-year-old female presented for a surgery for idiopathic scoliosis of the thoracic vertebra. Generalized muscle rigidity and tachycardia were revealed 1 hour 35 minutes after isoflurane administration. Then the body temperature was risen to 43degrees C within 10 minutes and the arterial blood gas analysis showed a severe respiratory and metabolic acidosis. Under the suspicion of malignant hyperthermia, the patient was treated by discontinuing all anesthetic agents, hyperventilation with 100% oxygen, surface cooling with ice pack and the administration of dantrolene sodium. But, the patient died of renal failure and disseminated intravascular coagulation after 50 days postoperatively.

摘要

恶性高热是一种潜在致命的高代谢综合征,其特征为骨骼肌强直和高热。我们有一名11岁女性因胸椎特发性脊柱侧弯接受手术。在给予异氟烷1小时35分钟后出现全身肌肉强直和心动过速。随后体温在10分钟内升至43摄氏度,动脉血气分析显示严重的呼吸性和代谢性酸中毒。在怀疑为恶性高热的情况下,患者接受了停用所有麻醉剂、100%氧气过度通气、冰袋体表降温以及给予丹曲林钠的治疗。但是,患者在术后50天死于肾衰竭和弥散性血管内凝血。

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