[Case of autonomic hyperreflexia treated with intravenous nicardipine].
We describe a case of 26-year-old male patient with autonomic hyperreflexia (AH) during colostomy. He had suffered paraplegia due to the 8th cervical spinal cord injury by a traffic accident 2 years before. The anesthesia was induced and maintained with propofol, fentanyl, ketamine and vecuronium. Vital signs including blood pressure (135-145/70-80 mmHg) and heart rate (55-65 beats x min(-1)), were stable at the beginning of the operation. However, blood pressure suddenly rose (220/ 120mmHg), and heart rate decreased (43 beats x min(-1)) associated with skin eruptions on his face and shoulder when the intestinal tract procedure was started. Diagnosis of AH was made. Then nicardipine 1 mg i.v. was given followed by nicardipine 2 microg x kg(-1) x min(-1) DIV Consequently, blood pressure (140-155/ 70-85 mmHg) and heart rate (75-85 beats x min(-1)) were stabilized. The operation was finished with no evidence of any complications. Nicardipine may be preferable in a patient with upper spinal cord injury undergoing operation in the paralyzed area.
Saito
Junichi
J
Department of Anesthesiology, Hirosaki University School of Medicine, Hirosaki 036-8562.
Kimura
Futoshi
F
Ishihara
Hironori
H
Hirota
Kazuyoshi
K
D000328:Adult; D000771:Anesthesia, Intravenous; D020211:Autonomic Dysreflexia / Q000188:drug therapy* / Q000209:etiology; D003125:Colostomy; D006801:Humans; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009529:Nicardipine / Q000008:administration & dosage*; D010264:Paraplegia / Q000150:complications; D013119:Spinal Cord Injuries / Q000150:complications
D009529:Nicardipine