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KMID : 0352120200350010017
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Journal of Kyung Hee University
2020 Volume.35 No. 1 p.17 ~ p.21
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Convulsion following Spinal Anesthesia and Dexmedetomidine Sedation for Arthroscopic Meniscectomy: A Case Report
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Lee Ji-Yoo
Kang Hee-Yong
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Abstract
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The number of spinal anesthetic procedure for abdominal or leg surgery has increased because it is considered to have more advantages, especially in high-risk patients, and fewer complications than general anesthesia. The most common complications related to spinal anesthesia are post-dural puncture headache, back pain, hematoma, abscess, paresthesia or motor weakness and myoclonus. Convulsion is rarely reported as a complication of spinal anesthesia with bupivacaine. However, in our case, a 38-year-old healthy woman had convulsive episode following intrathecal administration of bupivacaine and infusion of dexmedetomidine for sedation. Before the convulsion, she complained of nausea and dyspnea and showed severe bradycardia. Immediately, the patient lost consciousness, showed upward eyeball deviation accompanied with a jerking of the upper limbs; at that time the blood pressure was 88/46 mmHg, the heart rate was 32 beats/min and the oxygen saturation of the blood was not detected. The patient fully recovered after manual ventilation, injection of ephedrine and hydration but she could not remember the episode. The possible etiologic factors of this transient convulsion after spinal anesthesia are difficult to clarify. Therefore, through our case study, we would like to look into the cause of the case and use it as an opportunity to emphasize that spinal anesthesia may lead to severe complication so careful monitoring is important.
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KEYWORD
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Bradycardia, Convulsion, Spinal Anesthesiaㅣ Bupivacaine, Dexmedetomidine
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