title: Measurement of blood pressure in a thalidomide-impaired patient who required ovarian cystectomy: A case report.
abstract: BACKGROUND
  Thalidomide was available for use over-the-counter between 1958 and 1962, and more than 300 thalidomide-impaired people have been confirmed in Japan. Currently, thalidomide-impaired people are nearing the age of 50 years and sometimes require medical treatment or surgery. However, a sphygmomanometer cannot be used to measure the blood pressure in some thalidomide-impaired people because of upper-limb shortening or hypoplastic defects. We encountered a patient with thalidomide-related upper limb defects who required abdominal ovarian cystectomy.
  
  
  METHODS
  The patient was a 49-year-old woman (146.5cm, 35.9kg) with thalidomide-related upper-limb defects, but no dysplasia of the lower limbs, who underwent abdominal ovarian cystectomy. During the surgery, the patient's arterial blood pressure was monitored in her lower limbs by both non-invasive and invasive methods, and almost the same variations of the blood pressure between the invasive and non-invasive measurements were observed.
  
  
  CONCLUSIONS
  Usually, blood pressure measurements are performed in a non-invasive manner in the upper limbs, however, such measurement could not be performed in the present case. There are few reports of measurement of the blood pressure or surgery under anaesthesia in thalidomide-impaired patients, and we report here that it was useful to measure the blood pressure in the lower limbs in the current patient. Invasive arterial pressure measurements showed almost the same changes as the non-invasive pressure measurements, although the systolic blood pressure was 10-20mmHg lower than the noninvasively measured systolic blood pressure.
  
  
  CONCLUSIONS
  Non-invasive blood pressure measurements in the lower limbs might be useful in thalidomide-impaired patients requiring blood pressure monitoring, but further studies are required to validate this method.
authors.affiliation: Department of Anesthesiology, National Center for Global Health and Medicine Hospital, Tokyo, Japan. Electronic address: yshiga.chiba.u@gmail.com.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Shiga
authors.affiliation: Department of Anesthesiology, National Center for Global Health and Medicine Hospital, Tokyo, Japan. Electronic address: bass5fumiyo-n@ybb.ne.jp.
authors.forename: Fumiyo
authors.initials: F
authors.lastname: Nojiri
authors.affiliation: Department of General Internal Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan. Electronic address: ayoshiza@hosp.ncgm.go.jp.
authors.forename: Atsuto
authors.initials: A
authors.lastname: Yoshizawa
authors.affiliation: Department of Clinical Study and Informatics, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: tshimbo@hosp.ncgm.go.jp.
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.affiliation: Department of Anesthesiology, National Center for Global Health and Medicine Hospital, Tokyo, Japan. Electronic address: skawachi@niid.go.jp.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kawachi
keywords: Non-invasive blood pressure measurements; Thalidomide; Upper limb defects