Prolonged neuromuscular blockade in a patient with a normal genotype
Prolonged neuromuscular blockade in a patient with a normal genotype
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正常基因型患者的长期神经肌肉阻滞
DOI：
10.1111/j.1365-2044.1987.tb03015.x
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发表时间：
1987
期刊：
影响因子：
10.7
通讯作者：
S. Cherala
中科院分区：
文献类型：
--
作者：
S. Cherala
与术前值相比（从 130 毫米汞柱上升至 220 毫米汞柱）。窦性心动过速（每分钟 10 次心跳上升至每分钟 160 次），潮气末 Proz 增加至 7.3 kPa，尽管每分钟通气量为 10 升。 ：温度升高（35.5°C 升至 37.5°C）和周围血管舒张。外科医生还评论了腹膜腔的温度。然而，确实有。没有肌肉僵硬。尽管失血量超过一升，但这些变化在整个前腹壁开口处持续存在，并且通过处理肿瘤肿块而加剧。因此，采取了积极措施为患者降温。停止使用氟烷，并将呼吸系统改为无毒的呼吸系统。没有给予丹洛林，也没有发现腹内脓毒症的证据。一旦哈克马尼亚被排出，肿瘤的处理就停止了。高血压、心动过速和发热很快就消失了。我们认为没有必要筛查患者对恶性高热的易感性。组织学检查发现肿瘤为肺泡软肉瘤。这是一种非常罕见的肿瘤，仅占所有肉瘤 I 的四分之一，并且往往起源于极端组织的深层组织。通常来自骨骼肌内部，例如大腿的肌肉。）“Ihcy 通常是致命的。”这种转变以前被定义为恶性非嗜铬副神经节瘤。其他麻醉师是否经历过如此明显的生理变化？模仿恶性高热。对于腹膜后翻转较大的患者，麻醉期间如何处理？
pared with pre-operative values (rising from 130 to 220 mmHg). a sinus tachycardia ( I 10 beatslminute rising to 160 beatsjminute), an increased end tidal Proz of 7.3 kPa despite a minute volume of 10 litres. :in iiicrcasing coi-e tempcrature (35.5 C rising to 37.5 C ) and periphcral vasodilatation. The surgeons also remarked on the warmth of the peritoneal cavity. There was, however. n o muscle rigidity. These changes persisted throughout the opening of the anterior abdominal wall and were exacerbated by handling the tumuur mass, despite a blood loss greater than I litre. Activc measures were therefore taken to cool thc paticnt. Thc use of halothane was stoppcd and the breathing system was changed to one which was vitpour-free. No danlrolene was given arid no evidence of intra-abdominal sepsis was found. Once the hacmatonia had hecn cvacuatcd and handling o f the tumour had ceased. the hypertension, tachycardia and pyrexia rapidly settled. It was not thcrefnrc thought neccssary to screen the paticnt for susceptibility to malignant hyperpyrexia. On histological examination, the tumour was found to be an alveolar soft-part sarcoma. This is a very rarc tumour, accounting for only I n 4 of all sarcomata I and tends to arise from the deep tissues of the extreiiiitics. typically from within skeletal musclc such as the muscles of the thigh.) 'Ihcy are usually fatal. Such turnours wcrc previously defined as malignant nonchromaffin paraganglionomata. ' Have other anaesthetists experienced such marked physiological changes. mimicking malignant hyperpyrexia. during anaesthesia for patients with large retroperitoiieal turnours?