title: Autonomic hyperreflexia after spinal cord injury managed successfully with intravenous lidocaine: a case report.
abstract: BACKGROUND
  Some paraplegic patients may wish undergo some surgical procedures, like urological procedures, without anesthesia. However, these patients can develop autonomic hyperreflexia if cystoscopy is performed without anesthesia.
  
  
  METHODS
  We present a case of severe autonomic hyperreflexia in a 44-year-old male with spinal cord injury at the level of T4 during urologic procedure under sedation and analgesia successfully treated with intravenous lidocaine.
  
  
  CONCLUSIONS
  This case illustrates that patients with spinal cord injuries are likely to develop autonomic hyperreflexia during urological procedures performed without anesthesia. Health professionals should educate spinal cord injury patients regarding risks of this serious condition and be aware to prevent and manage autonomic hyperreflexia. In an acute episode, nifedipine, nitrates and captopril are the most commonly used and recommended agents. To our knowledge, this is the first case report of severe autonomic hyperreflexia treated successfully with intravenous lidocaine.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido Pinho, 4520-211 Santa Maria da Feira, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Leão
authors.affiliation: Director of the Department of Anesthesiology and Pain Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Figueiredo
keywords: Autonomic hyperreflexia; Intravenous lidocaine; Patient safety; Spinal cord injury