Benton N C, Wolgat R A
Department of Otolaryngology, Kaiser Permanente Medical Center, Redwood City, California 91402.
Ear Nose Throat J. 1993 Feb;72(2):130-1.
We describe a four-year-old boy of Indian descent who had elective adenotonsillectomy for chronic sore throat and partial airway obstruction. About 10 minutes into the procedure, the patient suddenly developed cardiac asystole. After prolonged cardiac resuscitation, recovery was achieved. No permanent neurologic deficits resulted. The child was later found to have a strong family history of Duchenne's muscular dystrophy (DMD) and an elevated serum creatine kinase level documented since shortly after birth. We reviewed several case reports substantiating the risk for cardiac arrest during general anesthesia in DMD patients, and we concluded that DMD is a little-known risk for cardiac arrest during general anesthesia. The otolaryngologist must be aware of this potential complication, because tonsillectomy and adenoidectomy are commonly indicated for children at an age when DMD may be subclinical.
我们描述了一名4岁的印度裔男孩，他因慢性咽喉痛和部分气道阻塞接受了择期腺样体扁桃体切除术。手术进行约10分钟后，患者突然发生心搏停止。经过长时间的心脏复苏后恢复。未留下永久性神经功能缺损。后来发现该患儿有杜氏肌营养不良症（DMD）的家族病史，且自出生后不久血清肌酸激酶水平就升高。我们查阅了几篇病例报告，证实了DMD患者在全身麻醉期间发生心脏骤停的风险，我们得出结论，DMD是全身麻醉期间心脏骤停的一个鲜为人知的风险。耳鼻喉科医生必须意识到这种潜在的并发症，因为扁桃体切除术和腺样体切除术通常适用于DMD可能处于亚临床阶段的儿童。
