SUCCESSFUL TREATMENT OF AN EPISODE OF MALIGNANT HYPERTHERMIA USING A LARGE DOSE OF DANTROLENE

被引：9

作者：

BLANK, JW

BOGGS, SD

机构：

[1] Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD

来源：

JOURNAL OF CLINICAL ANESTHESIA | 1993年 / 5卷 / 01期

关键词：

ANESTHESIA; ADVERSE EFFECTS OF; CREATINE PHOSPHOKINASE; DANTROLENE; MALIGNANT HYPERTHERMIA; RHABDOMYOLYSIS;

D O I：

10.1016/0952-8180(93)90092-S

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

This clinical case report describes the use of extremely high doses of dantrolene in the management of an episode of malignant hyperthermia (MH). A 6-year-old, 25 kg girl underwent anesthetic induction with halothane for an elective inguinal herniorrhaphy. Tachydysrhythmias, laryngospasm, opisthotonos, rhabdomyolysis, and profound metabolic acidosis ensued as features of an MH crisis. Initial dantrolene administration did not alleviate the symptoms. Increasing doses of dantrolene eventually totaling 42 mg/kg, along with symptomatic supportive care, were administered successfully to treat the event. It is postulated that the severe muscle rigidity may have precluded the circulation of dantrolene to its site of action. The role of the Malignant Hyperthermia Association of the United States (MHAUS) Hotline as a 24-hour consultative service is noted.

引用

页码：69 / 72

页数：4

共 14 条

[1]

Harrison, Malignant hyperthermia. Dantrolene-dynamics and kinetics, Br J Anaesth, 60, pp. 279-286, (1988)

[2]

Britt, Dantrolene—an update, Malignant Hyperthermia, pp. 326-368, (1987)

[3]

Flewellen, Nelson, Dantrolene dose response in malignant hyperthermia-susceptible (MHS) swine: method to obtain prophylaxis and therapeusis, Anesthesiology, 52, pp. 303-308, (1980)

[4]

Flewellen, Nelson, Jones, Arens, Wagner, Dantrolene dose response in awake man: implications for management of malignant hyperthermia, Anesthesiology, 59, pp. 275-280, (1983)

[5]

Britt, Dantrolene, Can Anaesth Soc J, 31, pp. 61-75, (1984)

[6]

Britt, The clinical aspects of malignant hyperthermia, Malignant Hyperthermia: Current Concepts, pp. 91-107, (1989)

[7]

Ellis, Castellion, Honkomp, Wessels, Carpenter, Halliday, Dantrolene, a direct acting skeletal muscle relaxant, J. Pharm Sci, 62, pp. 948-951, (1973)

[8]

Gronert, Schulman, Mott, Malignant Hyperthermia, Anesthesia, pp. 935-956, (1990)

[9]

McGilvery, Biochemistry: A Functional Approach, (1979)

[10]

Gronert, Ahern, Milde, Treatment of porcine malignant hyperthermia: lactate gradient from muscle to blood, Can Anaesth Soc J, 33, pp. 729-736, (1986)

← 1 2 →