Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso

Detalhes bibliográficos
Autor(a) principal: Bezerra, Dailson Mamede [UNESP]
Data de Publicação: 2018
Outros Autores: Bezerra, Eglantine Mamede, Silva Junior, Antonio Jorge, Amorim, Marco Aurélio Soares, Miranda, Denismar Borges de
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.1016/j.bjan.2015.03.004
http://hdl.handle.net/11449/168328
Resumo: Background and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4‐L5 and L5‐S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target‐controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non‐organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis.
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spelling Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de casoPostoperative visual loss due to conversion disorder after spine surgery: a case reportBlindnessConversion disorderDecubitus ventralGeneral anesthesiaLaminectomyBackground and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4‐L5 and L5‐S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target‐controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non‐organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis.Centro de Ensino e Treinamento Dr. José QuinanDefesa Profissional da Sociedade de Anestesiologia do Estado de Goiás (2015/2016)Universidade Estadual Paulista Júlio de Mesquita Filho (FMB/Unesp) Faculdade de MedicinaHospital Adventista de Belém Serviço de AnestesiologiaPontifícia Universidade Católica de Goiás (PUC/GO)Universidade Federal de Goiás (UFG)Universidade Estadual Paulista Júlio de Mesquita Filho (FMB/Unesp) Faculdade de MedicinaCentro de Ensino e Treinamento Dr. José QuinanDefesa Profissional da Sociedade de Anestesiologia do Estado de Goiás (2015/2016)Universidade Estadual Paulista (Unesp)Serviço de AnestesiologiaPontifícia Universidade Católica de Goiás (PUC/GO)Universidade Federal de Goiás (UFG)Bezerra, Dailson Mamede [UNESP]Bezerra, Eglantine MamedeSilva Junior, Antonio JorgeAmorim, Marco Aurélio SoaresMiranda, Denismar Borges de2018-12-11T16:40:48Z2018-12-11T16:40:48Z2018-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article91-95application/pdfhttp://dx.doi.org/10.1016/j.bjan.2015.03.004Brazilian Journal of Anesthesiology, v. 68, n. 1, p. 91-95, 2018.1806-907X0034-7094http://hdl.handle.net/11449/16832810.1016/j.bjan.2015.03.0042-s2.0-849555079502-s2.0-84955507950.pdfScopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengporBrazilian Journal of Anesthesiology0,320info:eu-repo/semantics/openAccess2023-12-23T06:15:54Zoai:repositorio.unesp.br:11449/168328Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-12-23T06:15:54Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
Postoperative visual loss due to conversion disorder after spine surgery: a case report
title Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
spellingShingle Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
Bezerra, Dailson Mamede [UNESP]
Blindness
Conversion disorder
Decubitus ventral
General anesthesia
Laminectomy
title_short Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
title_full Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
title_fullStr Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
title_full_unstemmed Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
title_sort Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso
author Bezerra, Dailson Mamede [UNESP]
author_facet Bezerra, Dailson Mamede [UNESP]
Bezerra, Eglantine Mamede
Silva Junior, Antonio Jorge
Amorim, Marco Aurélio Soares
Miranda, Denismar Borges de
author_role author
author2 Bezerra, Eglantine Mamede
Silva Junior, Antonio Jorge
Amorim, Marco Aurélio Soares
Miranda, Denismar Borges de
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Centro de Ensino e Treinamento Dr. José Quinan
Defesa Profissional da Sociedade de Anestesiologia do Estado de Goiás (2015/2016)
Universidade Estadual Paulista (Unesp)
Serviço de Anestesiologia
Pontifícia Universidade Católica de Goiás (PUC/GO)
Universidade Federal de Goiás (UFG)
dc.contributor.author.fl_str_mv Bezerra, Dailson Mamede [UNESP]
Bezerra, Eglantine Mamede
Silva Junior, Antonio Jorge
Amorim, Marco Aurélio Soares
Miranda, Denismar Borges de
dc.subject.por.fl_str_mv Blindness
Conversion disorder
Decubitus ventral
General anesthesia
Laminectomy
topic Blindness
Conversion disorder
Decubitus ventral
General anesthesia
Laminectomy
description Background and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4‐L5 and L5‐S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target‐controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non‐organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis.
publishDate 2018
dc.date.none.fl_str_mv 2018-12-11T16:40:48Z
2018-12-11T16:40:48Z
2018-01-01
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1016/j.bjan.2015.03.004
Brazilian Journal of Anesthesiology, v. 68, n. 1, p. 91-95, 2018.
1806-907X
0034-7094
http://hdl.handle.net/11449/168328
10.1016/j.bjan.2015.03.004
2-s2.0-84955507950
2-s2.0-84955507950.pdf
url http://dx.doi.org/10.1016/j.bjan.2015.03.004
http://hdl.handle.net/11449/168328
identifier_str_mv Brazilian Journal of Anesthesiology, v. 68, n. 1, p. 91-95, 2018.
1806-907X
0034-7094
10.1016/j.bjan.2015.03.004
2-s2.0-84955507950
2-s2.0-84955507950.pdf
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv Brazilian Journal of Anesthesiology
0,320
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 91-95
application/pdf
dc.source.none.fl_str_mv Scopus
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv
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