Blanloeil Y, Delaroche O, Tequi B, Gunst J P, Dixneuf B
Service d'anesthésie et de réanimation chirurgicale, hôpital G- et R-Laennec, France.
Ann Fr Anesth Reanim. 1996;15(2):189-91. doi: 10.1016/0750-7658(96)85041-6.
A toxic shock syndrome occurred after a femoral nail removal requiring revision surgery. After administration of suxamethonium (1 mg.kg-1), an apnoea prolonged over 45 minutes was observed. The trachea was extubated 105 minutes after suxamethonium administration. For the nail removal, two days before, the anaesthetic had been given by the same anaesthesiologist, with a similar protocol. Apnoea extended over 20 minutes. The day of the revision surgery, plasma cholinesterase activity was 410 UI.L-1 and reached 910 UI.L-1, 9 months later. Dibucaine number was 20 and fluorure number 17. The apnoea was in relation with a genetic plasma cholinesterase deficiency increased by the toxic shock syndrome. Shock and hepatic insufficiency were suspected to contribute to the decrease in plasma cholinesterase. Suxamethonium should be avoided in case of toxic shock syndrome.
在取出股骨钉并需要进行翻修手术之后发生了中毒性休克综合征。给予琥珀胆碱（1毫克/千克）后，观察到呼吸暂停延长超过45分钟。在给予琥珀胆碱105分钟后拔除气管插管。两天前，同一位麻醉医生采用类似方案进行了取出钉子的麻醉，当时呼吸暂停延长超过20分钟。翻修手术当天，血浆胆碱酯酶活性为410国际单位/升，9个月后升至910国际单位/升。地布卡因值为20，氟化物值为17。此次呼吸暂停与中毒性休克综合征导致的遗传性血浆胆碱酯酶缺乏有关。怀疑休克和肝功能不全导致了血浆胆碱酯酶降低。发生中毒性休克综合征时应避免使用琥珀胆碱。
