Prolonged muscle weakness following general anesthesia in a parturient on combined antiretroviral therapy--a case report.
We report a case of an otherwise healthy; ambulatory 32 year old parturient on combined antiretroviral therapy that developed prolonged muscle weakness needing postoperative artificial ventilation. Despite no preoperative indication of muscle weakness, she developed respiratory insufficiency following general anesthesia with drugs that are deemed safe for her condition. After ruling out all the likely causes for her respiratory insufficiency that needed 12 hrs of artificial ventilation, we address the issue of undiagnosed preoperative muscle weakness as a likely cause for her problem. The role of a preoperative neurological evaluation to caution the anesthesiologist of the likelihood of a possible need for prolonged artificial ventilation following general anesthesia in this subgroup of patients, emphasized.
Department of Anesthesia, Royal Hospital, Muscat, Sultanate Oman.
Jotish
J
Mathew
Madan Mohan
MM
Maddali
Jutta
J
Fahr
D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D002585:Cesarean Section; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D018908:Muscle Weakness / Q000209:etiology*; D011183:Postoperative Complications / Q000139:chemically induced / Q000503:physiopathology*; D011247:Pregnancy; D012121:Respiration, Artificial; D012129:Respiratory Function Tests