别紧张：线粒体肌病伴恶性高热易感性患者行妇科手术时选择区域麻醉作为主要麻醉方式的病例报告。
Don't stress: a case report of regional anesthesia as the primary anesthetic for gynecologic surgery in a patient with mitochondrial myopathy and possible malignant hyperthermia susceptibility.
机构信息
Mayo Clinic Department of Anesthesiology and Perioperative Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
出版信息
BMC Anesthesiol. 2019 Dec 14;19(1):226. doi: 10.1186/s12871-019-0909-1.
BACKGROUND
We aim to describe the evaluation and management of a patient with the uncommon combination of both mitochondrial myopathy and possible malignant hyperthermia susceptibility as an important source of information and as a valuable example of the role of regional anesthesia for patients with these diagnoses.
CASE PRESENTATION
A 24 year old woman with a history of possible mitochondrial myopathy and possible malignant hyperthermia susceptibility presented for gynecologic surgery. Surgery was well tolerated with combined spinal epidural anesthesia as well as sedation with midazolam, ketamine, and fentanyl.
CONCLUSIONS
Anesthetic management of patients with mitochondrial myopathy is challenging, made even more so with concurrent malignant hyperthermia susceptibility. This case adds an example to the literature of employing regional anesthesia as a safe approach to this complex care.
背景
我们旨在描述一位同时患有线粒体肌病和恶性高热易感性的患者的评估和管理，作为重要信息来源，并作为这些诊断患者采用区域麻醉的作用的有价值示例。
病例介绍
一位 24 岁女性，有潜在的线粒体肌病和恶性高热易感性病史，因妇科手术就诊。手术过程中采用了腰硬联合麻醉，并使用咪达唑仑、氯胺酮和芬太尼进行镇静，患者耐受良好。
结论
线粒体肌病患者的麻醉管理具有挑战性，同时存在恶性高热易感性时更为复杂。该病例为文献增加了一个采用区域麻醉作为这种复杂治疗安全方法的示例。
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