[A case of delayed awakening from general anesthesia caused by psychological unresponsiveness]. 2013

Yoshiaki Shin, and Daisuke Ono, and Yoko Watanabe, and Mizue Ishii, and Etsu Iwasaki, and Hiroyuki Kobayashi, and Tomihiro Fukushima, and Hiroaki Tokioka
Department of Anesthesiology, Okayama Red Cross General Hospital, Okayama 700-8607.

We report a case of an 85-year-old woman with delayed awakening from general anesthesia caused by psychological unresponsiveness. She underwent an open reduction of the right femoral bone fracture. Induction of general anesthesia was done with fentanyl, propofol, sevoflurane, and rocuronium. Anesthesia was maintained with sevoflurane and remifentanil without any incidents. After the operation she opened her eyes and tried to extubate the endtracheal tube and then she was extubated. She developed coma and did not respond to painful stimuli after extubation, but spontaneous breathing was maintained with stable hemodynamics. Although naloxone was given, she was still comatose. Her clinical neurological findings and the brain CT scan showed no organic abnormalities. The bispectral index showed the value of 85 to 95; 2.5 hrs after operation she moved her extremities in response to pain and 3.5 hrs after operation she gradually woke up and obeyed commands. After fully awakening she showed no clinical manifestations of psychological abnormality during her postoperative period and no sequela.

UI MeSH Term Description Entries
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000762 Anesthesia Recovery Period The period of emergence from general anesthesia, where different elements of consciousness return at different rates. Recovery Period, Anesthesia,Anesthesia Recovery Periods,Period, Anesthesia Recovery,Periods, Anesthesia Recovery,Recovery Periods, Anesthesia
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias

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