RESUMO
Spinal myoclonus following neuraxial anesthesia is rare. This report describes a case of myoclonus-like involuntary movement that occurred during the recovery from epidural anesthesia for a cesarean delivery. The patient's symptom improved with the administration of benzodiazepine, and the patient recovered with no neurological sequelae. In conclusion, epidural anesthesia can cause spinal myoclonus, which can be treated with a benzodiazepine.
Assuntos
Anestesia Epidural/efeitos adversos , Anestesia Obstétrica/efeitos adversos , Anticonvulsivantes/uso terapêutico , Cesárea , Midazolam/uso terapêutico , Mioclonia/tratamento farmacológico , Mioclonia/etiologia , Administração Intravenosa , Adulto , Período de Recuperação da Anestesia , Anestésicos Locais/administração & dosagem , Anticonvulsivantes/administração & dosagem , Bupivacaína/administração & dosagem , Bupivacaína/análogos & derivados , Feminino , Humanos , Injeções Epidurais , Levobupivacaína , Lidocaína/administração & dosagem , Midazolam/administração & dosagem , GravidezRESUMO
Arytenoid cartilage dislocation is not a common complication, but its delayed diagnosis reduces the therapeutic effect of treatment. A male patient underwent reversed total shoulder replacement surgery in the beach chair position under general anesthesia. The patient experienced postoperative hoarseness, and it was revealed that he had right arytenoid dislocation. Voice restoration was accomplished with closed reduction. We discussed changes in patient position during the operation and how they may contribute to the arytenoid dislocation. Flexion and a slight rotation of the neck during the operation can lead to an increase in intracuff pressure of the endotracheal tube. It is necessary to check neck position and monitor intracuff pressure in patients undergoing operations in the beach chair position. Also, the anesthesiologist should suspect arytenoid dislocation in the case of persistent hoarseness after surgery in the beach chair position.