Tanabe K, Ishiyama T, Suzuki A, Ohota S, Shimonaka H, Dohi S
Department of Anesthesia, Daiyuukai General Hospital, Ichinomiya.
Masui. 1994 Jan;43(1):119-21.
An elevation of creatine-kinase was noted postoperatively in a 50 year-old male who had cerebral aneurysm surgery under isoflurane, N2O and O2 anesthesia. Serum CK concentration reached as high as 5919 IU.l-1 immediately after surgery and elevation was associated with the temperature elevation of above 39.5 degrees C and port-wine urine. The postoperative course was uneventful and elevated serum creatine-kinase was corrected within next 6 days. Since elevated serum creatine-kinase is known to occur in acute stage of cerebrovascular accident, and since the influence of myocardial infarction, malignant hyperthermia and drugs could be neglected, we assumed that an abnormal elevation of CK values observed in the present patient resulted from stimulation of sympathetic nervous system due to cerebral bleeding and to hyperpermeability of sarcolemma of skeletal muscle.
一名50岁男性在异氟烷、N2O和O2麻醉下进行脑动脉瘤手术后，术后肌酸激酶升高。术后血清CK浓度立即高达5919 IU.l-1，升高与体温高于39.5摄氏度及葡萄酒色尿有关。术后病程平稳，血清肌酸激酶升高在接下来6天内恢复正常。由于已知血清肌酸激酶升高会在脑血管意外急性期出现，且心肌梗死、恶性高热和药物的影响可忽略不计，我们推测该患者观察到的CK值异常升高是由于脑出血刺激交感神经系统以及骨骼肌肌膜通透性增加所致。
