Thiopental持続投与による右心房内結石 : てんかん発作重積先天性筋ジストロフィーの1剖検例 Theiopental-Stone was found in the Right Atrium by Autopsy, in a Case with Congenital Muscular Dystrophy

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14歳の先天性筋ジストロフィー男児が突然の昏睡と呼吸停止をきたし, 翌日から痙攣重積に陥った. 痙攣はPB, DZP, PHTに抵抗性でThiopental-Naにより抑制された.<BR>減量すると痙攣再発するため, 同剤の約4mg/kg/hr投与を継続したが, ECGでA-Vblockの進行を示し, 心停止に至った.<BR>剖検で右心房内に直径2cmの結石が見いだされ, その組成はThiopentalが72%, 非溶解血漿蛋白が8%であった.<BR>同時投与していたIVH液とThiopental-Naを混合するin vitroの実験では, 後者が高濃度なほど明らかな結晶形成を認めた.<BR>難治発作へのThiopental-Naの持続投与, 特にアルカリ性薬品との併用では, 結晶 (結石) 形成にも注意する必要がある.

A boy, 14 years of age, with Fukuyama-type congenital muscular dystrophy, suddenly fell into coma and respiratory arrest. From the next day, he suffered convulsive status. His convulsive status was interrupted not by parenteral phenobarbital, intravenous diazepam, or phenytoin, but by thiopental-Na.<BR>About 4mg/kg/hr of continuous thiopental-Na iv injection was the successful dose for maintenance.<BR>Although, his convulsion was completely controlled, A-V block in ECG appeared and worsened untill his sudden cardiac arrest occured.<BR>From his right atrium, stone of 2cm in diameter was detected by autopsy.<BR>The stone was made from 72% of thiopental and 8% of unsoluble plasma protein.<BR>By the in vitro study, thiopental-Na showed cristal formation by mixture with IVH-solution used for him. And, the cristal formation was more remarkable in more thick thiopental-Na.<BR>Continuous thiopental iv injection in intractable convulsion should be carefully observed especially on its use in accompany with alkaline materials.

収録刊行物

  • てんかん研究 = Journal of the Japan Epilepsy Society

    てんかん研究 = Journal of the Japan Epilepsy Society 14(2), 142-146, 1996-06-30

    一般社団法人 日本てんかん学会

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各種コード

  • NII論文ID(NAID)
    10008555707
  • NII書誌ID(NCID)
    AN10043823
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    09120890
  • データ提供元
    CJP書誌  J-STAGE 
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