Monitored anesthesia care using dexmedetomidine and remifentanil for the hip surgery in a high risk patient with brain metastasis of lung cancer, cerebral infarction, seizure and quadriplegia: A case report

Park, Hye Yoon; Lee, Il Ok; Kong, Myoung Hoon; Kim, Nan Sook; Kim, Heezoo; Lim, Sang Ho; Lim, Byung Gun

Case Report

Neuroanesthesia

Anesthesia and Pain Medicine 2013;8(1):47-50.
Published online January 31, 2013.

Monitored anesthesia care using dexmedetomidine and remifentanil for the hip surgery in a high risk patient with brain metastasis of lung cancer, cerebral infarction, seizure and quadriplegia: A case report

Hye Yoon Park, Il Ok Lee, Myoung Hoon Kong, Nan Sook Kim, Heezoo Kim, Sang Ho Lim, Byung Gun Lim

Department of Anesthesiology and Pain Medicine, Guro Hospital, College of Medicine, Korea University, Seoul, Korea. bglim9205@korea.ac.kr

Abstract

To perform the major operation for high risk patients with both serious systemic diseases and major organ complications, the monitored anesthesia care could be available as a reasonable alternative for both general and regional anesthesia when it is impossible to administer; however, the choice of analgesics and sedatives is still an important and difficult task. We present a high risk patient who suffers from neurologic complications including decreased consciousness caused by brain metastasis of lung cancer, cerebral infarction, quadriplegia and seizure as well as decreased respiratory function and bleeding tendency. When performing the operation on hip joints, we administered both dexmedetomidine as a major sedative, and remifentanil as an adjunct analgesic; as a result, we could successfully perform the monitored anesthesia care without any complications including cardiovascular instability, respiratory depression, and seizure.

Key Words: Cerebral infarction, Dexmedetomidine, Monitored anesthesia care, Quadriplegia, Remifentanil, Seizure