Purkis I E, Curtis J E
Can Med Assoc J. 1965 Dec 4;93(23):1200-4.
When phenothiazines and barbiturates fail to control the spasms of tetanus, total paralysis induced by muscle relaxants may be the only way of keeping the patient alive. The hazards of this technique are illustrated in this report of a patient with severe tetanus who was totally paralyzed for 26 days. Cardiac arrest, ileus, atelectasis, anemia, and limb contractures were among the problems dealt with. Devoted nursing care, an experienced medical team, respirators, minute ventilation meters, an airway pressure alarm, a hypothermia unit, a cardiac monitor pacemaker and facilities for determining blood-gas tensions were all necessary in the successful treatment of this patient. It is suggested that patients with severe tetanus should be transferred, under anesthesia and artificially ventilated, to hospitals possessing all these facilities.
当吩噻嗪类药物和巴比妥类药物无法控制破伤风痉挛时，使用肌肉松弛剂导致的全身麻痹可能是挽救患者生命的唯一方法。本报告介绍了一名严重破伤风患者全身麻痹26天的病例，说明了该技术的风险。治疗过程中出现了心脏骤停、肠梗阻、肺不张、贫血和肢体挛缩等问题。悉心的护理、经验丰富的医疗团队、呼吸机、分钟通气量计、气道压力报警器、低温治疗设备、心脏监测起搏器以及测定血气张力的设备，都是成功治疗该患者所必需的。建议将严重破伤风患者在麻醉和人工通气的情况下转至具备所有这些设备的医院。
