對小劑量Dantrolene有良好反應之惡性高熱的病例報告

Malignant Hyperthermia with Excellent Response to Small Dose of Dantrolene

惡性高熱是一種與全身麻醉有關的麻醉急症，早期診斷與迅速處理是惡性高熱的治療重點。Dantrolene是治療的首選藥物，所有施行全身麻醉的醫療機構都應該準備此藥物以應付可能的狀況。但是，其相對的高價格與只有三年的保存期限使得建議的大量藥品準備似乎值得再做進一步地討論，尤其對甚少施行全身麻醉的小醫院來說更是如此。我們提出兩個對小劑量dantrolene即有良好反應的病例報告，並討論可行的處理方法，同時探討更少的dantrolene準備量對小型醫療機構來說是否不失為一可行的替代方案。

Malignant hyperthermia (MH) is an operative emergency associated with general anesthesia. Early diagnosis and prompt treatment are the keynotes in management of MH. Dantrolene is the only specific drug and all of the institutions where general anesthesia is a daily routine should have a stockpile of this drug for the rare occurrence of MH. Nonetheless, the enormous expenditure on stockpile and 3-year validity make a large reserve of the drug to forestall MH, a disorder of rare occurrence, seems disputable, especially in small hospitals where general anesthesia is seldom practiced. We herein report two cases of MH with excellent response to small doses of dantrolene and then discuss the way of practicable management and debate on the question of whether fewer stock of dantrolene is an alternative way for hospitals of smaller scale.