Christiaens F, Gepts E, D'Haese J, Camu F
Department of Anesthesiology, Flemish Free University of Brussels Medical School, Belgium.
Acta Anaesthesiol Belg. 1995;46(2):93-7.
A 6-year old female child received succinylcholine (1 mg.kg-1) and isoflurane (concentrations of 1.5-2 percent) and developed at the end of surgery a hypermetabolic syndrome suggestive of malignant hyperthermia (MH) with masseter muscle spasm, muscle rigidity, tachypnea, systolic hypertension (140 mm Hg), tachycardia (205 beats.min-1), hypercarbia (end expiratory CO2 71 mmHg), and an increase in body temperature (39.2 degrees C). The child responded well to therapy which included cooling, hyperventilation with pure oxygen and dantrolene administration. However, blood creatine kinase and myoglobin elevations were moderate (respectively 375 IU.L-1 and 114 micrograms.L-1) and an in vitro halothane and caffeine contracture test was negative. Differential diagnostic proposals are discussed and compared to the clinical incident.
一名6岁女童接受了琥珀酰胆碱（1毫克/千克）和异氟烷（浓度为1.5%-2%），在手术结束时出现了提示恶性高热（MH）的高代谢综合征，伴有咬肌痉挛、肌肉强直、呼吸急促、收缩期高血压（140毫米汞柱）、心动过速（205次/分钟）、高碳酸血症（呼气末二氧化碳分压71毫米汞柱）以及体温升高（39.2摄氏度）。该患儿对包括降温、纯氧过度通气和给予丹曲林在内的治疗反应良好。然而，血液肌酸激酶和肌红蛋白升高程度中等（分别为375国际单位/升和114微克/升），体外氟烷和咖啡因挛缩试验为阴性。文中讨论了鉴别诊断建议并与该临床事件进行了比较。
