Lewandowski K B
Can Anaesth Soc J. 1982 Jul;29(4):372-6. doi: 10.1007/BF03007528.
Administration of succinylcholine to normal individuals results in alterations in muscle membrane integrity expressed as a slight increase in the concentrations of creatine phosphokinase (CK) in serum and appearance of small amounts of myoglobin in the urine, but without clinical symptoms. Subjects with strabismus due to congenital muscular dystrophy may develop more significant rhabdomyolysis expressed as muscle stiffness and weakness, massive myoglobinuria, marked elevation of serum CK and other enzymes, metabolic acidosis, tachycardia and moderate elevation of body temperature. In some cases grave malignant hyperthermia with significant hypoxia, metabolic acidosis, tachycardia and marked abnormalities in serum electrolyte concentrations may cause irreversible damage to the central nervous system and other vital organs and death. A case of difficult anaesthesia for a six year old boy belonging to family affected with muscular dystrophy is presented. More attention must be given to preoperative examination (anamnesis, serum enzymes) or ophthalmological patients and more careful monitoring during anaesthesia and in the early postoperative period must be instituted to prevent and treat complications induced by succinylcholine and volatile anaesthetic agents.
给正常个体注射琥珀酰胆碱会导致肌肉膜完整性改变，表现为血清中肌酸磷酸激酶（CK）浓度略有升高以及尿中出现少量肌红蛋白，但无临床症状。患有先天性肌营养不良所致斜视的受试者可能会发生更显著的横纹肌溶解，表现为肌肉僵硬和无力、大量肌红蛋白尿、血清CK及其他酶显著升高、代谢性酸中毒、心动过速和体温适度升高。在某些情况下，严重的恶性高热伴有明显的缺氧、代谢性酸中毒、心动过速和血清电解质浓度显著异常，可能会对中枢神经系统和其他重要器官造成不可逆损害并导致死亡。本文介绍了一名患有肌营养不良症家族的6岁男孩的困难麻醉病例。对于眼科患者，必须更加重视术前检查（病史、血清酶），并且在麻醉期间和术后早期必须进行更仔细的监测，以预防和治疗由琥珀酰胆碱和挥发性麻醉剂引起的并发症。
