Rhabdomyolysis after laparoscopic radical nephrectomy -A case report-

Kim, Tae Kwane; Yoon, Jun Rho; Lee, Myeong Ha

doi:10.4097/kjae.2010.59.s.s41

Cited by 11 publications

(9 citation statements)

References 10 publications

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“…[12] RM can also be seen as a result of compression of muscular tissue due to surgical positioning in prolonged laparoscopic or robotic surgeries.…”

Section: Discussionmentioning

confidence: 99%

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Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

et al. 2017

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BACKGROUND:In patients undergoing robot-assisted radical prostatectomy (RARP), pneumoperitoneum, intraoperative fluid restriction and prolonged Trendelenburg position may cause rhabdomyolysis (RM) due to hypoperfusion in gluteal muscles and lower extremities. In this study, it was aimed to assess effects of body mass index (BMI), comorbidities, intra-operative positioning, fluid restriction and length of surgery on the development of RM in RARP patients during the perioperative period.SUBJECTS AND METHODS:The study included 52 American Society of Anesthesiologists I–II patients aged 50–80 years with BMI >25 kg/m2, who underwent RARP. Fluid therapy with normal saline (1 ml/kg/h) and 6% hydroxyethyl starch 200/05 (1 ml/kg/h) was given during the surgery. Charlson comorbidity index (CCI), operation time (OT) and Trendelenburg time (TT) were recorded. Blood samples for creatine phosphokinase (CPK), blood urea nitrogen, creatinine (Cr), aspartate aminotransferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), creatinine kinase-MB, cardiac troponin I and arterial blood gases were drawn at baseline and on 6, 12, 24 and 48 h. RM was defined by serum CPK level exceeding 5000 IU/L.RESULTS:Seven patients met predefined criteria for RM. There were positive correlations among serum CPK and Cr, AST, ALT and LDH levels. However, there was no significant difference in BMI, OT and TT between patients with or without RM (P > 0.05). CCI scores were higher in patients with RM than those without (3.00 ± 0.58 vs. 2.07 ± 0.62; P < 0.01). No renal impairment was detected among patients with RM at the post-operative period.CONCLUSIONS:It was found that comorbid conditions are more important in the development of RM during RARP rather than BMI, OT or TT. Patients with higher comorbidity are at risk for RM development and that this should be kept in mind at follow-up and when informing patients.

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“…[12] RM can also be seen as a result of compression of muscular tissue due to surgical positioning in prolonged laparoscopic or robotic surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…[2] Post-operative RM can be observed after vascular, neurosurgical and more commonly urological interventions. Risk factors include age (40–50 years of age), male gender, high body mass index (BMI),[3] perioperative overhydration, prolonged surgery[4] and surgical positioning (flexed lateral decubitus position and STP).…”

Section: Introductionmentioning

confidence: 99%

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

et al. 2017

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“…Karcher et al [ 7 ] report the case of an obese patient who developed rhabdomyolysis with ARF and hepatic dysfunction. Kim et al [ 12 ] and Park et al [ 13 ] also observed a marked elevation of AST and ALT. The mechanisms for liver dysfunction have not yet been elucidated.…”

Section: Discussionmentioning

confidence: 96%

Rhabdomyolysis recognized after elevation of liver enzymes following prolonged urologic surgery with lateral decubitus position -A case report-

Lee

Kim

2011

Korean J Anesthesiol

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The classic signs and symptoms of rhabdomyolysis are non-specific and not present in all cases, and mild cases might go unrecognized. We present a case of rhabdomyolysis recognized in a 68-year-old man after elevation of liver enzymes following prolonged urologic surgery. The patient's postoperative course was concerned with elevated serum aspartate aminotransferase and alanine aminotransferase without any clinical manifestations on the first postoperative day. After examining the serum creatine kinase and myoglobin levels, the patient was diagnosed with rhabdomyolysis. After 16 days, he was discharged with fully recovered liver enzymes and creatine kinase. We suggest that sufficient perioperative attentions should be given to patients at a higher risk of rhabdomyolysis.

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“…Lumbar plexopathy can occur as the result of direct trauma to the lumbar plexus, space-occupying lesions in the peritoneal cavity, complications after aortic surgery, and metabolic diseases [ 1 , 2 ]. Patients who undergo surgery under general anesthesia or regional anesthesia in the lateral decubitus, prone, or lithotomy positions experience complications that damage the soft tissues of the muscles or nerves [ 3 - 6 ]. There have been reports of patients who underwent a nephrectomy in the lateral decubitus position, where severe pressure on the opposite paraspinal muscles or gluteal muscles during surgery induced rhabdomyolysis [ 3 , 7 ].…”

mentioning

confidence: 99%

“…Patients who undergo surgery under general anesthesia or regional anesthesia in the lateral decubitus, prone, or lithotomy positions experience complications that damage the soft tissues of the muscles or nerves [ 3 - 6 ]. There have been reports of patients who underwent a nephrectomy in the lateral decubitus position, where severe pressure on the opposite paraspinal muscles or gluteal muscles during surgery induced rhabdomyolysis [ 3 , 7 ]. We report a patient who underwent a nephrectomy in the lateral decubitus position, experienced injury in the opposite paraspinal and iliopsoas muscles, and also evidenced lumbar plexopathy.…”

mentioning

confidence: 99%

Lumbar plexopathy after radical nephrectomy -A case report-

Lee

Jeong

Park

2012

Korean J Anesthesiol

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Lumbar plexopathy is characterized by an abrupt onset of sensory disturbances, weakness, and loss of deep tendon reflexes of lower extremities. The various causes of lumbar plexopathy include trauma, infections, space-occupying lesion, vascular diseases, metabolic diseases, and the use of drugs such as heroin. Postoperative rhabdomyolysis occurs secondary to prolonged muscle compression due to surgical positioning. Herein, we report a case of lumbar plexopathy, complicating an injury to the paraspinal muscle and iliopsoas muscle that occurred in the flexed lateral decubitus position following radical nephrectomy.

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Rhabdomyolysis after laparoscopic radical nephrectomy -A case report-

Cited by 11 publications

References 10 publications

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

Is rhabdomyolysis an anaesthetic complication in patients undergoing robot-assisted radical prostatectomy?

Rhabdomyolysis recognized after elevation of liver enzymes following prolonged urologic surgery with lateral decubitus position -A case report-

Lumbar plexopathy after radical nephrectomy -A case report-

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