Richardson M G, Setty G K, Rawoof S A
Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital, NY 14642, USA.
Anesth Analg. 1996 Feb;82(2):382-5. doi: 10.1097/00000539-199602000-00030.
Patients with type 1 neurofibromatosis (NF-1) have been reported to have prolonged responses to nondepolarizing (ND) neuromuscular blockers (NMBs). Responses to succinylcholine (SCh) have been described as increased, decreased, or normal. The purpose of this study was to assess responses to NMBs in NF-1 patients in order to determine the clinical significance of abnormal responses. We retrospectively identified all NF-1 patients who received anesthetics at Strong Memorial Hospital between January 1, 1984 and December 31, 1994. We then reviewed all anesthetic records to classify responses to NMBs as normal, abnormal, or indeterminate. Records of 114 anesthetics provided to 44 NF-1 patients were reviewed. Nondepolarizing NMBs were used during 73 anesthetic cases in 38 patients. Responses were normal in 69 cases and indeterminate in 4 (3 in patients with normal responses during other anesthetics). SCh was used during 42 anesthetic cases in 23 patients. Responses were normal in all but one case (indeterminate) in a patient who had had other documented normal responses. Standard milligram per kilogram doses of NMBs were used in all cases, and in none was there evidence of abnormal response. The risk of abnormal response to NMBs in individuals with NF-1 appears to be minimal. We recommend no alteration in dosing of either SCh or ND NMBs in patients with NF-1.
据报道，1型神经纤维瘤病（NF-1）患者对非去极化（ND）神经肌肉阻滞剂（NMBs）的反应时间延长。琥珀酰胆碱（SCh）的反应被描述为增强、减弱或正常。本研究的目的是评估NF-1患者对NMBs的反应，以确定异常反应的临床意义。我们回顾性确定了1984年1月1日至1994年12月31日期间在斯特朗纪念医院接受麻醉的所有NF-1患者。然后，我们查阅了所有麻醉记录，将对NMBs的反应分为正常、异常或不确定。对提供给44例NF-1患者的114次麻醉记录进行了回顾。38例患者在73例麻醉病例中使用了非去极化NMBs。69例反应正常，4例不确定（3例在其他麻醉期间反应正常的患者）。23例患者在42例麻醉病例中使用了SCh。除1例（不确定）有其他记录正常反应的患者外，所有患者反应均正常。所有病例均使用标准毫克/千克剂量的NMBs，且均无异常反应的证据。NF-1个体对NMBs异常反应的风险似乎最小。我们建议NF-1患者的SCh或ND NMBs剂量无需改变。
