Ferrari F, D'Alessandro S, Pietrandrea G, Villani A
Servizio di Anestesia e Rianimazione, Ospedale Pediatrico Bambino Gesù, Roma.
Minerva Anestesiol. 1997 Oct;63(10):311-4.
In order to prevent malignant hyperthermia (MH) in children, the authors are currently using a perioperative anaesthetic protocol. In vitro contracture tests with halothane and caffein are performed in selected patients: those with previous signs suggestive of MH, but not severe enough for a definite diagnosis; those with susceptibility to MH in their relatives; those affected by myopathies or other disorders very frequently associated with MH. Even though CK should be considered an unreliable predictor of MH susceptibility, trigger agents are avoided in children with high and constant CK levels. However, prophylactic dantrolene is never employed. In this way, over the last decade no episodes of classic malignant hyperthermia in a large number of children submitted to anaesthesia (more than 50,000) have been observed.
为预防儿童恶性高热（MH），作者目前采用围手术期麻醉方案。对部分患者进行氟烷和咖啡因的体外挛缩试验：有既往提示MH但严重程度不足以确诊的体征者；亲属有MH易感性者；患有肌病或其他常与MH相关疾病者。尽管肌酸激酶（CK）应被视为MH易感性的不可靠预测指标，但CK水平持续升高的儿童应避免使用触发剂。然而，从不使用预防性丹曲林。通过这种方式，在过去十年中，未观察到大量接受麻醉的儿童（超过50000例）出现经典恶性高热发作。
