RESUMO
Perioperative radial nerve injury is a rare anesthetic complication, and is rarely seen in association with the use of an automatic blood pressure monitor. As far as we know, only one case has been reported. Here, we report a 26-year-old healthy, lean female who sustained acute radial nerve palsy after appendectomy. A dropped wrist improved 5 days later. The cause of the radial neuropathy is discussed. We recommend that when an automatically cycling blood pressure monitor is used on a lean patient, caution should be taken against such a complication.
Assuntos
Monitores de Pressão Arterial/efeitos adversos , Neuropatia Radial/etiologia , Doença Aguda , Adulto , Feminino , HumanosRESUMO
Postoperative paraplegia is a rare complication after epidural analgesia and often occurs with spinal hematoma or cord injury. We present the case of a 16-year-old girl who suffered from a tumor mass in the neck and abdomen who underwent gynecologic operation. Preoperatively, liver metastasis was found by computed tomography. Pathologic findings revealed that the abdominal mass was an ovarian dermoid cyst. After the operation, the patient complained of paraplegia while receiving epidural analgesia for postoperative pain control. A peripheral primitive neuroectodermal tumor in the thoracic and lumbar spines with spinal cord compression was later detected using magnetic resonance imaging. Learning from this case, we suggest that when a patient is preoperatively diagnosed with tumor metastasis, back pain and soreness, spinal cord compression from tumor metastasis should be excluded before epidural analgesia is implemented.
Assuntos
Analgesia Epidural/efeitos adversos , Tumores Neuroectodérmicos Primitivos/complicações , Paraplegia/etiologia , Complicações Pós-Operatórias/etiologia , Neoplasias da Coluna Vertebral/complicações , Adolescente , Feminino , Humanos , Dor Pós-Operatória/terapia , Neoplasias da Coluna Vertebral/secundárioRESUMO
Acute intermittent porphyria (AIP) is an inherited metabolic disorder caused by deficiency of porphobilinogen deaminase, an enzyme found in the synthetic pathway of heme. Acute attack of AIP may be precipitated by many factors during operation and anesthesia, including fasting, dehydration, stress, infection, and drugs. Acute attack of AIP is likely fatal. Therefore, the drugs recommended as being safe in anesthesia for porphyria patients are up-to-dately refreshed and renovated and the identification of whether a drug is safe or not is based on cumulative anecdotal experiences. Here, we report the safe use of rocuronium and sevoflurane for long exposure in a patient affected with acute intermittent porphyria.
