Assuntos
Hipnose , Bloqueio Nervoso , Anestésicos Locais , Hospitais Universitários , Glândula TireoideRESUMO
We present the case of a 65-year-old man with latent thiamine deficiency who manifested lower limb neuropathy after receiving spinal anesthesia. We discuss our care of this patient and include a discussion of thiamine deficiency generally, its possible origins, symptoms, and recommended techniques for treatment of these patients.
Assuntos
Raquianestesia , Extremidade Inferior/inervação , Polineuropatias/etiologia , Deficiência de Tiamina/complicações , Idoso , Eletrocardiografia/métodos , Seguimentos , Humanos , Masculino , Parestesia/etiologia , Polineuropatias/fisiopatologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Deficiência de Tiamina/diagnóstico , Ressecção Transuretral da Próstata/métodos , Resultado do Tratamento , Complexo Vitamínico B/uso terapêuticoRESUMO
OBJECTIVES: The objective of this case report is to describe a femoral nerve injury after a psoas compartment block (PCB) and to discuss the probable mechanisms of injury and neuron regeneration. To date, this is the first report of severe femoral nerve injury after PCB. CASE REPORT: A 60-year-old, American Society of Anesthesiologists II woman underwent right total knee replacement under general anesthesia and continuous PCB for postoperative analgesia. Postoperatively, she showed signs of severe femoral nerve injury. A physical therapy program and muscle electrical stimulation were instituted and continued for 6 months. The patient recovered completely with no residual motor or sensory deficit and had no other complication. CONCLUSIONS: Severe nerve injuries after regional anesthesia techniques remain infrequent and probably unreported. Our case report suggests that severe femoral nerve injury should be added to the list of reported complications during PCB. This case report is also encouraging because it shows the possibility of a good recovery after such injury.