RESUMEN
We report a case of transient blindness, part of a TURP syndrome, in a 65 year old man undergoing TUR of the prostate under centro-neuron block. Irrigating fluid consisted of 1.5% glycine. As a result, serum levels of glycine increased to 12,470 mols.l-1 (N176-332 mumols.l-1). We attribute this loss of vision to glycine toxicity.
Asunto(s)
Ceguera/etiología , Glicina/efectos adversos , Prostatectomía/efectos adversos , Anciano , Anestesia Raquidea , Anestésicos Locales/administración & dosificación , Glicina/administración & dosificación , Humanos , Soluciones Hipotónicas/efectos adversos , Lidocaína/administración & dosificación , Masculino , Bloqueo Nervioso , Irrigación Terapéutica/efectos adversosRESUMEN
A 31-year-old women, 34 weeks gestation with intrauterine fetal death, and transverse lie with impending rupture of the uterus due to obstructed labor, was scheduled for urgent cesarean section. On preoperative anesthetic assessment, she was diagnosed to have HELLP syndrome based on clinical findings (subsequently confirmed by laboratory results). She was anesthetized taking the necessary precautions. Her intra and postoperative course is described. The case demonstrates how the anesthetist is often confronted by undiagnosed HELLP syndrome for urgent cesarean section and has limited time for investigations. He should depend on his clinical acumen to diagnose and treat appropriately for a favorable maternal outcome.
