上肢DVTによって合併されたダントロレンによる悪性高温症の成功管理:症例報告
Mostafa Nagy1,2,3,4, Syed Nasir Mustafa1,2,3, Rayan Muawad1,2,3
1Department of Anesthesia, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia.
Saudi journal of anaesthesia
|February 19, 2026
まとめ
麻酔に対する希少だが危険な反応である悪性高温症 (MH) は,鼻腔外科手術を受けた患者で発生した. ダントロレンによる迅速な治療は完全な回復につながったが,治療を受けた肢体には深静脈血栓症 (DVT) が発症した.
科学分野:
- アネステシオロジー アネステシオロジー
- 薬理学 薬理学とは
- クリティカルケア・メディシン
背景:
- 悪性高温症 (MH) は,全身麻酔の希少で生命を脅かす高代謝合併症である.
- 揮発性麻酔薬とサクシニルコリンによって引き起こされるMHは,手術室で重要な課題を提示します.
- このケースは,既往歴や家族的な傾向のない患者の突然発症したMHを強調しています.
研究 の 目的:
- 機能内視鼻腔外科手術 (FESS) 中の悪性高温症 (MH) の症例を報告する.
- MHの早期認識と迅速な管理の重要性を強調する.
- MH治療後の潜在的な合併症について話し合う.
主な方法:
- 40歳の男性患者は,FESSの麻酔誘導から45分後にMHの症状を発症した.
- MHの臨床的兆候が認識され,ダントロレンは直ちに投与されました.
- ハイパーメタボリズムの積極的な管理を含むサポートケア措置が開始されました.
主要な成果:
- 患者は,MHの急性代謝危機から完全に回復した.
- MHの成功管理にもかかわらず,患者さんはダントロレンが投与された肢体で上肢深静脈血栓症 (DVT) を発症しました.
- 患者の関連した家族歴や事前の麻酔合併症は認められませんでした.
結論:
- 早期診断とダントロレンの迅速な投与は,MHの成功管理に不可欠です.
- 麻酔医は,既知の危険因子のない患者でも,MHに対して警戒し続けなければなりません.
- 深静脈血栓症 (DVT) は,MH症例におけるダントロレンの投与後の潜在的な合併症である可能性があります.
関連する概念動画
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
2.2K
Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...
2.2K
Skeletal Muscle Relaxants: Therapeutic Uses
1.2K
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
1.2K
Cardiomyopathy II: Dilated Cardiomyopathy
802
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
802
Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
Pulmonary Embolism III: Nursing Management
759
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
759
Diphtheria
191
Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
191


