[Dissociative stupor as a postoperative consequence of general anesthesia].
A 31-year-old woman failed to awaken after an uneventful general anesthesia (propofol, alfentanil and 65% N2O in oxygen) for laparoscopic resection of an ovarian cyst. After the operation she was extubated and vital signs were stable. However, the patient remained unresponsive even to painful stimuli for about 2 h. Just before we performed a computed tomogram of the brain to exclude a cerebral lesion we noticed that she blinked. We hypothesized that unconsciousness was due to a dissociative stupor. After administration of sublingual lorazepam the patient woke up promptly and was alert and normal for the rest of the hospital stay. In conclusion, after exclusion of a pharmacological or organic cause for postoperative unconsciousness, dissociative stupor may be a reason for apparent coma after general anesthesia.
Abteilung für Anästhesie und Operative Intensivmedizin, Klinikum Kempten-Oberallgäu gGmbH. mathias.haller@klinikum-kempten.de
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Haller
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Kiefer
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Vogt
D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D003128:Coma / Q000188:drug therapy / Q000209:etiology*; D004213:Dissociative Disorders / Q000139:chemically induced / Q000523:psychology; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy; D008140:Lorazepam / Q000627:therapeutic use; D010048:Ovarian Cysts / Q000473:pathology; D014057:Tomography, X-Ray Computed
D018757:GABA Modulators; D008140:Lorazepam