Schulte-Sasse U
Klinik für Anaesthesie und Operative Intensivmedizin, Städtisches Krankenhaus Heilbronn.
HNO. 1995 Nov;43(11):676-9.
Acute rhabdomyolysis with hyperkalemia has been followed by ventricular dysrhythmia, cardiac arrest and death after the administration of succinylcholine to apparently healthy children who were subsequently found to have undiagnosed skeletal muscle myopathies. Boys have mostly been affected. Reports of anesthesia emergencies from the United States and Germany have indicated that serious side effects of succinylcholine are not as rare as previously thought. This disorder often presents as sudden cardiac arrest within minutes after the administration of the drug. The tragedy is that an apparently healthy child dies abruptly during what was considered to be a relatively uncomplicated surgical procedure (most often in ENT surgery). Due to the abrupt onset of rhabdomyolysis, routine resuscitative measures are likely to be unsuccessful. Extraordinary measures (including institution of extracorporeal circulation) and prolonged efforts have resulted in successful resuscitation of some cases. Since there are usually no signs or symptoms to alert the practitioner to patients at risk, the use of succinylcholine in children should be reserved for emergency intubations or instances in which immediate securing of the airway is necessary.
在给表面健康但随后被发现患有未确诊骨骼肌肌病的儿童注射琥珀酰胆碱后，出现了急性横纹肌溶解伴高钾血症，继而发生室性心律失常、心脏骤停和死亡。受影响的大多为男孩。来自美国和德国的麻醉紧急情况报告表明，琥珀酰胆碱的严重副作用并不像以前认为的那样罕见。这种病症通常在用药后几分钟内表现为突然的心脏骤停。悲剧在于，一个表面健康的儿童会在被认为是相对简单的外科手术过程中突然死亡（最常见于耳鼻喉科手术）。由于横纹肌溶解症发病突然，常规的复苏措施可能无法成功。采取特殊措施（包括建立体外循环）并长时间努力后，部分病例成功复苏。由于通常没有迹象或症状提醒从业者注意有风险的患者，儿童使用琥珀酰胆碱应仅限于紧急插管或需要立即确保气道安全的情况。
