精神病医生需要注意的是:在电治疗期间,使用麻醉剂苏西尼尔胆 (Suxamethonium) 有恶性高温症的风险
Masaki Nakano1,2, Michitaka Funayama3,4, Taketo Takata3
1Department of Neuropsychiatry, Ashikaga Red Cross Hospital, 284-1 Yobe, Ashikaga-city, Tochigi, 326-0843, Japan. mnakano236@gmail.com.
BMC psychiatry
|June 4, 2024
概括
恶性高温症 (MH) 是一种严重的疾病,在使用顺胆时,可能在电疗法 (ECT) 后发生. 本病例报告详细介绍了ECT后的延迟MH反应,强调需要对患者进行警的术后监测.
科学领域:
- 麻醉学 麻醉学
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 恶性高温症 (MH) 是一种罕见的,可能致命的超代谢性肌肉病,由挥发性麻醉剂和顺胆引发.
- 顺胆经常用于电疗法 (ECT),以促进肌肉放松.
- 之前没有报告过ECT后的MH病例,ECT后的MH发病的典型时间过程仍然未定义.
研究的目的:
- 报告电疗法 (ECT) 后可能致命的恶性高温症的第一个病例.
- 描述ECT后MH的延迟发病和临床表现.
- 强调在精神病治疗的背景下识别和管理MH的重要性.
主要方法:
- 一个79岁的女性患者因严重抑郁症接受ECT的案例介绍.
- 在ECT期间使用顺胆来缓解肌肉松.
- 对MH的生命体征和临床表现的监测.
- 怀疑MH的dantrolene的治疗方法.
主要成果:
- 患者在ECT两小时后出现了严重的MH症状,包括发烧 (40.2°C),心动减速 (140/分钟),严重高血压 (>200 mmHg) 和肌肉硬.
- 症状在24小时内达到顶峰,并成功地用dantrolene治疗 (60mg初始剂量,随后是20mg和60mg).
- 患者的体温恢复正常 (36.2°C),肌肉硬性在丹特罗给药后两天内消失.
结论:
- 这是第一个被记录的恶性高温症病例,发生在电治疗后.
- 该病例表明,在ECT后,MH的发病时间延迟,这强调了精神病医生需要继续保持警.
- 及时识别和立即使用丹特烯治疗对于管理ECT后可能致命的MH发作至关重要.
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