Kolb M E, Horne M L, Martz R
Anesthesiology. 1982 Apr;56(4):254-62. doi: 10.1097/00000542-198204000-00005.
Anesthesiologists from 65 institutions participated in a multicenter study to assess the efficacy of lyophilized intravenous dantrolene sodium in treating anesthetically related malignant hyperthermia (MH). Of 21 patients treated with the drug, eight were judged to have unequivocal MH and were treated according to study protocol. Three were judged to have probable MH and were also treated according to study protocol. All 11 recovered without sequelae from MH and without adverse drug effects. A mean dantrolene dose of 2.5 mg/kg in these patients produced significant changes in clinical and biochemical parameters suggestive of decreased cellular metabolism. Four patients with unequivocal MH were treated with intravenous dantrolene more than 24 h after the diagnosis of MH; this delay in treatment of clinical signs in these patients, the mortality rate was 75 per cent, which is comparable to that reported without dantrolene. The six remaining patients had episodes of questionable MH during or subsequent to anesthesia and were treated with dantrolene. There was insufficient evidence to justify an unequivocal or probable diagnosis of MH, and they, therefore, were not included in the study. All survived and had no adverse drug reactions. Dantrolene therapy resulted in a statistically significantly lower mortality rate than would be expected in MH patients. The study supports animal data suggesting that dantrolene is specific in reversing MH.
来自65家机构的麻醉医生参与了一项多中心研究，以评估冻干静脉注射丹曲林钠治疗麻醉相关恶性高热（MH）的疗效。在接受该药物治疗的21例患者中，8例被判定为明确的MH，并按照研究方案进行治疗。3例被判定为可能的MH，也按照研究方案进行治疗。所有11例患者均从MH中康复，无后遗症，也无药物不良反应。这些患者的丹曲林平均剂量为2.5mg/kg，临床和生化参数出现显著变化，提示细胞代谢降低。4例明确的MH患者在诊断为MH后24小时以上接受静脉注射丹曲林治疗；这些患者临床症状治疗延迟，死亡率为75%，这与未使用丹曲林报道的死亡率相当。其余6例患者在麻醉期间或之后出现可疑的MH发作，并接受了丹曲林治疗。没有足够的证据支持明确或可能的MH诊断，因此，他们未被纳入研究。所有患者均存活，且无药物不良反应。丹曲林治疗导致的死亡率在统计学上显著低于MH患者预期的死亡率。该研究支持了动物数据，表明丹曲林在逆转MH方面具有特异性。
