# 使用succinylcholine與sevoflurane誘導麻醉後不久，手術室個案出現咬肌僵硬、呼氣末CO2快速升至70、心搏過速與體溫飆至40°C。優先處置是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391877&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

使用succinylcholine與sevoflurane誘導麻醉後不久，手術室個案出現咬肌僵硬、呼氣末CO2快速升至70、心搏過速與體溫飆至40°C。優先處置是什麼？

## 選項

1. 停止誘發藥物（succinylcholine、揮發性麻醉氣體），呼叫支援，給予dantrolene 2.5 mg/kg IV，冷卻個案，以100%氧氣過度換氣，並治療高血鉀與酸中毒 **✔ 正確答案**
2. 改用另一種揮發性麻醉氣體
3. 再給succinylcholine以放鬆肌肉
4. 增加麻醉藥以加深鎮靜

**正確答案: 1**

## 解析

正確（2）：惡性高熱症是常染色體顯性ryanodine受體疾病，由succinylcholine與揮發性麻醉藥誘發。典型表現包括咬肌僵硬、EtCO2上升、高熱、心搏過速、酸中毒、橫紋肌溶解。解毒藥：立即給予dantrolene IV 2.5 mg/kg（可重複至最高10 mg/kg）。停止誘發因子、冷卻，處理高血鉀與酸中毒。（1,3,4）可能致命。

## 深入解析

記憶提示 MH誘發因子 =「Sux + 揮發性氣體（sevo/iso/des）」。解毒藥是dantrolene。有家族史者使用非誘發性麻醉。記得MHAUS熱線。

## 臨床情境

情境 18歲接受選擇性手術，已給予succinylcholine + sevoflurane。新出現咬肌僵硬、EtCO2 70、HR 145、體溫40°C、皮膚斑駁。

## 重要概念

- **惡性高熱症** — 由succinylcholine與揮發性麻醉藥誘發的遺傳性高代謝危機。
- **Dantrolene丹曲林** — 骨骼肌鬆弛藥；阻斷鈣離子釋放；為惡性高熱症解毒藥。
- **MH誘發因子** — Succinylcholine + 揮發性麻醉藥（sevoflurane、isoflurane、desflurane）。

## 相同主題題目

- [A nurse is reviewing the morning lab results for an adult client receiving warfarin for at…](https://mymerci.kr/pages/nclex_q.php?qn_id=360515&lang=zh-tw)
- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=zh-tw)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=zh-tw)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=zh-tw)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=zh-tw)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=zh-tw)
- [An 80-year-old male with heart failure is prescribed digoxin 0.125 mg daily. During mornin…](https://mymerci.kr/pages/nclex_q.php?qn_id=372686&lang=zh-tw)
- [A 38-year-old female with rheumatoid arthritis is being discharged with a new prescription…](https://mymerci.kr/pages/nclex_q.php?qn_id=372687&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=391877&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=391877&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=391877&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=391877&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=391877&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。_