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[产后妇女使用琥珀胆碱后发生致命性心律失常,随后被发现患有强直性肌营养不良症]

[Fatal arrhythmia following administration of suxamethonium in a postpartum woman subsequently found to have dystrophia myotonica].

作者信息

Rozendaal F W, Rupreht J

机构信息

Academisch Ziekenhuis Rotterdam-Dijkzigt, afd. Anesthesiologie.

出版信息

Ned Tijdschr Geneeskd. 1996 Jun 22;140(25):1317-9.

PMID:8710011
Abstract

A 28-year-old woman died of irreversible ventricular fibrillation after administration of succinylcholine because of post partum curettage. Afterwards it became known she had undiagnosed myotonic dystrophy. She also had metabolic acidosis because of haemorrhagic hypovolaemia resulting in a probably elevated serum K+ concentration preoperatively. Succinylcholine given to patients with myotonic dystrophy may lead to life threatening hyperkalaemia and cardiac arrest. Therapy should be aimed at immediate lowering of serum K+ concentration with calcium, sodium bicarbonate and hyperventilation.

摘要

一名28岁女性在产后刮宫术时因使用琥珀胆碱后死于不可逆的心室颤动。后来发现她患有未被诊断出的强直性肌营养不良症。她还因出血性低血容量导致术前血清钾浓度可能升高而出现代谢性酸中毒。给患有强直性肌营养不良症的患者使用琥珀胆碱可能会导致危及生命的高钾血症和心脏骤停。治疗应旨在立即用钙剂、碳酸氢钠和过度通气降低血清钾浓度。

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