Lapisatepun Warangkana, Arkarattanakul Supawan
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Anesthesiology, Faculty of Medicine, Mae Fah Luang University Hospital, Chiang Rai, Thailand.
Case Rep Anesthesiol. 2020 Feb 22;2020:6562896. doi: 10.1155/2020/6562896. eCollection 2020.
Malignant hyperthermia is a rare pharmacogenetic disorder triggered by depolarizing muscle relaxant and potent volatile anesthetic agents. An MH crisis is an emergency and life-threatening event requiring early recognition and prompt management. Dantrolene is the specific antagonist of MH. The authors report the case of a 9-year-old boy who underwent an emergency bronchoscopy to remove a foreign body and developed masseter rigidity after succinylcholine and sevoflurane exposure. The anesthesia team diagnosed an MH event, and the event was managed immediately with supportive treatment, dantrolene, being administered within 10 minutes. The patient survived and had a good outcome without any complications. We suggest that it is essential for anesthesia providers to recognize the need for intraoperative vigilance, prompt recognition, and treatment, and dantrolene sodium should be readily available in every hospital.
恶性高热是一种由去极化肌肉松弛剂和强效挥发性麻醉剂引发的罕见药物遗传学疾病。恶性高热危象是一种紧急且危及生命的事件，需要早期识别和迅速处理。丹曲林是恶性高热的特效拮抗剂。作者报告了一名9岁男孩的病例，该男孩接受急诊支气管镜检查以取出异物，在使用琥珀酰胆碱和七氟醚后出现咬肌痉挛。麻醉团队诊断为恶性高热事件，并立即进行处理，在10分钟内给予了支持治疗及丹曲林。患者存活且预后良好，无任何并发症。我们建议麻醉人员必须认识到术中保持警惕、及时识别和治疗的必要性，并且每家医院都应随时备有丹曲林钠。
