低劑量Dantrolene治療惡性高熱之案例報告

Management of Malignant Hyperthermia with Low-Dose Dantrolene: Case Report

本文為一位15歲男性因橈骨和尺骨幹骨折接受全身麻醉手術，在給予揮發性麻醉劑Sevoflurane後，惡性高熱的症狀在麻醉期間變得越來越明顯，例如：高碳酸血症，心動過速，體溫上升，儘速給予低劑量Dantrolene 40mg先控制惡性高熱的症狀，再以靜脈滴注方式給予Dantrolene 40mg預防惡性高熱復發。因揮發性麻醉劑或去極化神經肌肉阻斷劑引發的惡性高熱是一種罕見且可能致命的疾病，如果可以早期診斷和及時給予治療，即使是低劑量的Dantrolene也可以降低惡性高熱的死亡率。

Herein report a case of 15-year-old male who received general anesthesia in preparation for surgical procedures to repair radius and ulnar shaft fracture. After administration of volatile anesthetic (Sevoflurane), the following symptoms of malignant hyperthermia became manifest during anesthesia: hypercarbia, tachycardia, and hyperthermia. The patient was treated successfully with 40mg Dantrolene administered within minutes and another 40mg of Dantrolene given intravenously as reinforcement. Malignant hyperthermia, triggered by volatile anesthetic gases or the depolarizing muscle relaxant, is a rare and potentially fatal condition. Early diagnosis and prompt treatment with even low-dose Dantrolene are essential in reducing the mortality due to this disease.