Postoperative Rhabdomyolysis Following General Anesthesia: A Case Report

全身麻醉後發生橫紋肌溶解症：病例報告

姜翰良(Han-Liang Chiang) ； 賈元一(Yuan-Yi Chia)

《南臺灣醫學雜誌》 13卷1期 (2017/06) Pp. 29-33

https://doi.org/10.6726/MJST.201706_13(1).0004

摘要

Postoperative rhabdomyolysis is rare but life-threatening adverse effect after general anesthesia. Severe lower extremities pain and soreness for two days after discharge from postoperative care unit was diagnosed rhabdomyolysis due to elevated serum creatinine kinase above 100,000 unit, and Cola-like urine was noted. Early recognition, appropriate fluid challenge and correction of electrolyte imbalance are the main keys in preventing patient mortality and morbidity. Postoperative muscle pain and soreness should not be overlooked which underlying disease would be progressing. Drugs selection for anesthesia planning should be more considerate for patients have multiple chronic medications. We will discuss the detail in the following section.

關鍵字

rhabdomyolysis ； succinylcholine ； statin ； myotoxicity

並列摘要

術後發生橫紋肌溶解症是在麻醉之後少見但是會有生命危險的併發症。我們報告一位病人在出恢復室兩天後發生下肢嚴重的疼痛和酸痛。他被診斷為橫紋肌溶解症因為肌酸酐的數值超過十萬單位，且發有可樂顏色尿液。提早辨識到這個診斷及積極的輸液補充和離子不平衡的校正是可以避免病人死亡及併發症的主要關鍵。術後肌肉痠痛應該不可被輕忽或許病程已經在進展了。麻醉計劃藥物的選擇在多種慢性病的患者是需要考慮更多的。

並列關鍵字

橫紋肌溶解症 ； 短效性神經肌肉鬆弛劑 ； 降血脂藥 ； 肌肉毒性