PDF(Pubmed)
Abstract：
BACKGROUND: Malignant hyperthermia (MH) is a rare yet serious medical complication that typically arises following general anesthesia or the administration of specific anesthetics. Due to the infrequency of MH, anesthesiologists often lack sufficient expertise in identifying and managing it, leading to misdiagnosis and inappropriate treatment. There is an urgent need to enhance the diagnosis and management of MH through the utilization of relevant tools.
METHODS: In this case, a 52-year-old woman underwent radical cervical cancer surgery under general anesthesia, with no family or significant medical history. She experienced a gradual increase in end-tidal carbon dioxide (ETCO2) to a maximum of 75 mm Hg and a rise in body temperature from 36.5 to 37.5 °C in a very short period, as well as a blood gas analysis showing a pH of 7.217.
METHODS: The anesthesiologist immediately used The WeChat applet-based National Remote Emergency System for Malignant Hyperthermia (MH-NRES), and the score was 40, which indicated that the patient was very likely to have MH.
METHODS: We immediately discontinued sevoflurane and switched total intravenous anesthesia to maintain general anesthesia, with a rapid intravenous infusion of dantrolene sodium.
RESULTS: The ETCO2 and the temperature quickly dropped to normal, followed by successful completion of the surgery, and the patient was discharged 8 days after surgery.
CONCLUSIONS: The experience can provide a basis use of MH-NRES and improve the ability of anesthesiologists to deal with intraoperative MH as well as increase the survival probability of patients.
METHODS: In this case, a 52-year-old woman underwent radical cervical cancer surgery under general anesthesia, with no family or significant medical history. She experienced a gradual increase in end-tidal carbon dioxide (ETCO2) to a maximum of 75 mm Hg and a rise in body temperature from 36.5 to 37.5 °C in a very short period, as well as a blood gas analysis showing a pH of 7.217.
METHODS: The anesthesiologist immediately used The WeChat applet-based National Remote Emergency System for Malignant Hyperthermia (MH-NRES), and the score was 40, which indicated that the patient was very likely to have MH.
METHODS: We immediately discontinued sevoflurane and switched total intravenous anesthesia to maintain general anesthesia, with a rapid intravenous infusion of dantrolene sodium.
RESULTS: The ETCO2 and the temperature quickly dropped to normal, followed by successful completion of the surgery, and the patient was discharged 8 days after surgery.
CONCLUSIONS: The experience can provide a basis use of MH-NRES and improve the ability of anesthesiologists to deal with intraoperative MH as well as increase the survival probability of patients.
摘要：
背景：恶性高热（MH）是一种罕见但严重的医学并发症，通常在全身麻醉或施用特定麻醉剂后出现。由于MH的频率不高,麻醉师通常缺乏足够的专业知识来识别和管理它，导致误诊和不当治疗。迫切需要通过利用相关工具来加强MH的诊断和管理。
方法：在这种情况下，一名52岁的妇女在全身麻醉下接受了宫颈癌根治术，没有家族或重大病史。她在很短的时间内经历了潮气末二氧化碳（ETCO2）逐渐增加到最高75mmHg，体温从36.5升高到37.5°C，以及血气分析显示pH值为7.217。
方法：麻醉师立即使用基于微信小程序的恶性高热国家远程应急系统（MH-NRES），得分为40分，这表明患者很可能患有MH。
方法：我们立即停止七氟醚，并切换全静脉麻醉以维持全身麻醉，快速静脉输注丹曲林钠。
结果：ETCO2和温度迅速下降到正常，随后手术成功完成,术后8天患者出院。
结论：该经验可为MH-NRES的使用提供依据，提高麻醉医师处理术中MH的能力，增加患者的生存概率。
方法：在这种情况下，一名52岁的妇女在全身麻醉下接受了宫颈癌根治术，没有家族或重大病史。她在很短的时间内经历了潮气末二氧化碳（ETCO2）逐渐增加到最高75mmHg，体温从36.5升高到37.5°C，以及血气分析显示pH值为7.217。
方法：麻醉师立即使用基于微信小程序的恶性高热国家远程应急系统（MH-NRES），得分为40分，这表明患者很可能患有MH。
方法：我们立即停止七氟醚，并切换全静脉麻醉以维持全身麻醉，快速静脉输注丹曲林钠。
结果：ETCO2和温度迅速下降到正常，随后手术成功完成,术后8天患者出院。
结论：该经验可为MH-NRES的使用提供依据，提高麻醉医师处理术中MH的能力，增加患者的生存概率。
