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[恶性高热——丹曲林治疗结果。病例报告]

[Malignant hyperthermia - therapy results with dantrolene. A case report].

作者信息

Wagner W, Feldmann E

出版信息

Anasth Intensivther Notfallmed. 1983 Oct;18(5):270-1.

PMID:6660445
Abstract

A 5-year-old previously healthy girl, received general anaesthesia for performing an appendectomy. After administration of succinyl choline (20 mg, twice repeated) and halothane (increasing to 2 per cent by volume), the following symptoms of malignant hyperthermia became manifest during anaesthesia: rigor, tachycardia, cardiac dysrhythmia, temperature increase to 42.6 degrees C; anaesthesia was effected with 2 litres O2/min, 4 litres N2O/min, halothane 1.5-2 per cent by volume, using the Kuhn system. Cooling reduced the temperature at first to 40.6 degrees C and subsequently, with additional intravenous administration of dantrolene (initially rapidly 20 mg equal 1 mg/kg body weight, then 10 mg/kg body weight X 24 hrs) within an hour to 37.5 degrees C. The postoperative phase was uncomplicated. The pattern of symptoms and therapy are critically reviewed. Basing on the cases described in literature, as known to the authors, the value of dantrolene in respect of treatment of malignant hypothermia in man is reviewed.

摘要

一名5岁的既往健康女孩接受全身麻醉以进行阑尾切除术。在给予琥珀酰胆碱(20毫克,重复两次)和氟烷(浓度增至2%体积分数)后,麻醉期间出现了以下恶性高热症状:寒战、心动过速、心律失常、体温升至42.6摄氏度;使用库恩系统,以每分钟2升氧气、每分钟4升氧化亚氮、1.5 - 2%体积分数的氟烷进行麻醉。降温措施最初将体温降至40.6摄氏度,随后,在一小时内通过额外静脉注射丹曲林(最初快速注射20毫克即1毫克/千克体重,然后10毫克/千克体重×24小时),体温降至37.5摄氏度。术后阶段无并发症。对症状和治疗模式进行了批判性回顾。基于作者所知的文献中描述案例,对丹曲林在治疗人类恶性高热方面的价值进行了回顾。

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