悪性高熱と思われた1症例

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A 30-year-old man was anesthetized with GOE (E: Enflurane) slow induction and SCC was given intravenously for intubation. When the anesthesiologist tried oral intubation he noticed rigidity of the masseter muscle and discontinued the anesthetic agents immediately. Two hours after recovery from anesthesia we found port-wine-colored urine. Myoglobine of both serum and urine were 25, 000 and 960, 000ng/dl and serum GOT, LDH and CPK were 586 Ku. 2499 Wu. and 106, 000 Iu., respectively, All the data returned to nearly normal values within seven days. Perspiration was noted though there had been only slight fever (37°C) for several days. Systemic circulation did not show any significant changes throughout the course without slight tachycardia. Diuretics and intravenous transfusion of about 5, 000ml/day were given to maintain a recommended urine output of 200ml/hour in order to preserve anal function.For prevention of malignant hyperthermia past history, family anamnesis and preoperation test must be examined, however at present prediction is not always possible on the basis of these data. If one suspects malignant hyperthermia, the best therapy is the following: (1) discontinuation of anesthetic agents, (2) rapid and effective cooling, (3) avoidance of hypoxia and (4) treatment of developing acidosis. One should obtain expert evaluation from an anesthesiologist.
耳鼻咽喉科臨床学会の論文