Avargues P, Cros A M, Dardel E, Darriet M, Biteau N
Département d'Anesthésie-Réanimation IV, Hôpital Pellegrin, Enfants, Bordeaux.
Ann Fr Anesth Reanim. 1995;14(6):511-3. doi: 10.1016/s0750-7658(05)80494-0.
A case of neuromuscular blockade of about 200 min of duration, in a 9-year-old boy from mivacurium 0.15 mg.kg-1 is reported. The diagnosis was delayed, after onset of the first signs of recovery, due to the lack of monitoring of neuromuscular transmission. The neuromuscular blockade was reversed with neostigmine 0.04 mg.kg-1. Complete reversal required fifty minutes. The presence of an abnormal genetic variant of pseudocholinesterases was demonstrated by the measurements of pseudocholinesterase activity and dibucaine number. The importance of monitoring of neuromuscular transmission for diagnosis and treatment of mivacurium-induced neuromuscular blockade is underlined.
报告了一例9岁男孩因米库氯铵0.15mg/kg导致约200分钟神经肌肉阻滞的病例。由于缺乏对神经肌肉传递的监测，在首次出现恢复迹象后诊断被延迟。用新斯的明0.04mg/kg逆转神经肌肉阻滞。完全逆转需要50分钟。通过测定假性胆碱酯酶活性和二丁卡因值证实存在假性胆碱酯酶异常基因变体。强调了监测神经肌肉传递对诊断和治疗米库氯铵诱导的神经肌肉阻滞的重要性。
