Dexmedetomidine for chronic spinal cord injured patient

Lee, Ki Hwa

doi:10.1007/s00540-014-1823-9

J Anesth

2014

DOI: 10.1007/s00540-014-1823-9

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Dexmedetomidine for chronic spinal cord injured patient

Ki Hwa Lee

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Monitored Anesthesia Care for a Patient with Chronic Spinal Cord Injury Undergoing Orchiectomy

Yamada

Negita

Okamoto

et al. 2019

JJSCA

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Autonomic dysreflexia (AD) is a matter of concern in anesthetic management for patients with chronic spinal cord injury. The patient was a 56-year-old man with complete paralysis from the 11th thoracic vertebra and below. He was scheduled for an orchiectomy to treat a left scrotal abscess. He reported no history of AD in activities of daily living. Since intravesical operation was not planned for this procedure, the possibility of intraoperative AD was considered to be low. The procedure could have been performed without anesthesia, but it was performed with monitored anesthesia care (MAC) to respond rapidly in case of AD onset. The surgery proceeded with continuous administration of dexmedetomidine (DEX) and intermittent administration of fentanyl. The bispectral index value was 35-78 and Richmond Agitation-Sedation Scale score was-1 to-2. AD did not occur during the surgery, and the anesthesia was managed safely. DEX has been reported to exert an inhibitory effect on AD. Therefore, this drug may be useful as a sedative during MAC for patients with spinal cord injury.

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Monitored Anesthesia Care for a Patient with Chronic Spinal Cord Injury Undergoing Orchiectomy

Yamada

Negita

Okamoto

et al. 2019

JJSCA

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Paraplegic Patient for Lower Limb Surgery

Wadhwa¹,

Saxena²,

Saha³

2022

MAMC Journal of Medical Sciences

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Patients with spinal cord injury 4–8 weeks back presenting for non-spinal elective surgery, present a unique challenge to the anesthesiologist. The perioperative concerns include potential for perioperative autonomic hypereflexia, muscle spasms, respiratory inadequacy, controversies regarding the use of muscle relaxants and opioids as well as medico-legal and technical issues associated with administration of regional anesthesia. Both general as well as regional anesthesia has been used for surgery on the insensate part below the level of injury with variable success but no standard definitive anesthetic management is recommended. We present our case series of monitored anesthesia care administration in paraplegic patients who presented for lower limb surgeries.

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Dexmedetomidine for chronic spinal cord injured patient

Cited by 2 publications

References 3 publications

Monitored Anesthesia Care for a Patient with Chronic Spinal Cord Injury Undergoing Orchiectomy

Monitored Anesthesia Care for a Patient with Chronic Spinal Cord Injury Undergoing Orchiectomy

Paraplegic Patient for Lower Limb Surgery

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