下顎骨骨折術後に発症した横紋筋融解症の1例 A case of rhabdomyolysis occurring after surgery for a mandibular fracture
Rhabdomyolysis results from the release of skeletal muscle contents (myogloblin, creatinine kinase) and causes renal damage.<BR>We report a case of rhabdomyolysis that developed after a by mandibular fracture operation under general anesthesia.<BR>The patient was an 18-year-old man who underwent operation for surgical repositioning and fixation of the mandible, preformed under general anesthesia with sevoflurane. The course of anesthesia was uneventful, and the patient recovered uneventfully. Two hours postoperatively, dark red urine was voided. On the 1st postoperative day, the creatinine kinase (CK) was 38700 IU/I and increased further to 73900 IU/I at reexamination. He had tenderness of the right brachial muscle, and dark red urine presisted. Rhabdomyolysis caused by general anesthesia was diagnosed. The patient received an infusion of extracellular fluid, and CK normalized on the 11th postoperative day. As postoperative malignant hyperthermia (MH) was suspected, the Ca<SUP>2 +</SUP>-induced Ca<SUP>2 +</SUP>release (CICR) rate was examined. CICR was unaccelerated, ruling out a predisposition to MH. Seven months later, the fixation plates were removed with the patient under local anesthesia. There were no complications.
日本口腔外科学会雑誌 53(1), 33-37, 2007-01-20
Japanese Society of Oral and Maxillofacial Surgeons