# 手術中25歲病人於sevoflurane與succinylcholine後突發頻脈、下顎僵硬、ETCO2倍增、體溫40.4°C。團隊處置?複選。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=zh-tw  
> language: zh-TW  
> subject: Physiological Adaptation  
> category: PA

## 題目

手術中25歲病人於sevoflurane與succinylcholine後突發頻脈、下顎僵硬、ETCO2倍增、體溫40.4°C。團隊處置?複選。

1

dantrolene 2.5 mg/kg IV bolus,重複至總10 mg/kg

2

以冰冷靜脈輸液與體表降溫積極降溫

3

以100%高流量氧過度換氣

4

重啟succinylcholine以緩解咀嚼肌痙攣

5

立即停用揮發性麻醉劑與succinylcholine

## 解析

惡性高熱為揮發性麻醉劑與succinylcholine誘發之遺傳性骨骼肌離子通道病。治療:停用誘發藥、dantrolene 2.5 mg/kg(總10 mg/kg)、100%氧高流量過度換氣以洗出CO2、積極降溫(冰冷生理食鹽水、冰塊、灌洗)至38°C、處理高鉀與酸中毒。麻醉迴路上活性碳濾器降低殘留揮發劑。重新使用succinylcholine屬禁忌。家屬需安排篩檢諮商。

## 深入解析

MH車:dantrolene(Ryanodex 250 mg瓶比舊Dantrium 20 mg快)、無菌水、降溫用具。死亡率因迅速給予dantrolene由70%降至5%以下。

## 臨床情境

家族有不明麻醉死亡史。手術中止。

## 重要概念

- **惡性高熱** — RYR1通道病 — 肌細胞內鈣大量釋放。
- **Dantrolene** — Ryanodine受體拮抗劑 — MH特異性解毒劑。
- **ETCO2** — 潮氣末CO2 — 急速上升為MH最早期可靠徵象。

## 相同主題題目

- [A 58-year-old patient with metastatic lung cancer is admitted with progressive dyspnea, hy…](https://mymerci.kr/pages/nclex_q.php?qn_id=372843&lang=zh-tw)
- [A trauma patient who sustained blunt chest injury becomes acutely diaphoretic and hypotens…](https://mymerci.kr/pages/nclex_q.php?qn_id=372844&lang=zh-tw)
- [A patient with stage 5 chronic kidney disease has missed two scheduled hemodialysis sessio…](https://mymerci.kr/pages/nclex_q.php?qn_id=372845&lang=zh-tw)
- [An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse …](https://mymerci.kr/pages/nclex_q.php?qn_id=373126&lang=zh-tw)
- [Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGE…](https://mymerci.kr/pages/nclex_q.php?qn_id=373127&lang=zh-tw)
- [A 55-year-old patient on post-op day 5 from an extensive abdominal surgery suddenly develo…](https://mymerci.kr/pages/nclex_q.php?qn_id=373402&lang=zh-tw)
- [Four adults with asthma arrive at the urgent care. Which presentation indicates the MOST s…](https://mymerci.kr/pages/nclex_q.php?qn_id=373879&lang=zh-tw)
- [An 11-year-old is admitted with new-onset diabetic ketoacidosis (DKA): blood glucose 612 m…](https://mymerci.kr/pages/nclex_q.php?qn_id=374873&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=375024&lang=vi)

---

More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw)

_僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_