Talaván Serna J, Belmonte Bayo L, Gil Melgosa L, Murciano García F, Rodríguez Martínez S
Servicio de Anestesiología y Reanimación, Hospital Obispo Polanco, Teruel, España.
Servicio de Anestesiología y Reanimación, Hospital Obispo Polanco, Teruel, España.
Rev Esp Anestesiol Reanim (Engl Ed). 2021 Sep 17. doi: 10.1016/j.redar.2021.02.011.
Familial hypokalaemic periodic paralysis (FHPP) is an uncommon genetic disease characterized by muscle weakness associated with hypokalaemia. Episodes are precipitated by drugs, stress, metabolic diseases, hypothermia or infection. We report the case of a 38-year-old pregnant women with FHPP who underwent epidural analgesia for labour. Pregnant women with FHPP require multidisciplinary management involving an anaesthesiologist, a gynaecologist and a paediatrician. It is important to maintain normothermia, prevent hyperventilation, monitor electrolytes, avoid glucose infusions and medications that cause hypokalaemia, and administer potassium supplements when required. Locoregional techniques should be preferred over general anaesthesia. Early epidural analgesia reduces the risk of pain that could trigger an episode of FHPP. In the case of general anaesthesia, drugs that can cause malignant hyperthermia should be avoided, and short-acting non-depolarizing neuromuscular blockers with blockade-depth monitoring should be used.
家族性低钾性周期性麻痹（FHPP）是一种罕见的遗传性疾病，其特征为与低钾血症相关的肌肉无力。发作可由药物、压力、代谢疾病、体温过低或感染诱发。我们报告了一例38岁患有FHPP的孕妇，她在分娩时接受了硬膜外镇痛。患有FHPP的孕妇需要麻醉医生、妇科医生和儿科医生参与的多学科管理。维持正常体温、防止过度通气、监测电解质、避免输注葡萄糖和使用导致低钾血症的药物，并在需要时补充钾非常重要。局部区域技术应优于全身麻醉。早期硬膜外镇痛可降低可能引发FHPP发作的疼痛风险。在全身麻醉的情况下，应避免使用可导致恶性高热的药物，并应使用具有阻滞深度监测的短效非去极化神经肌肉阻滞剂。
