Anesth Pain Med.  2013 Jan;8(1):47-50.

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 HY
• Lee IO
• Kong MH
• Kim NS
• Kim H
• Lim SH
• Lim BG

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.

Keyword

Cerebral infarction; Dexmedetomidine; Monitored anesthesia care; Quadriplegia; Remifentanil; Seizure

MeSH Terms

Analgesics
Anesthesia
Anesthesia, Conduction
Brain
Cerebral Infarction
Consciousness
Dexmedetomidine
Hemorrhage
Hip
Hip Joint
Humans
Hypnotics and Sedatives
Lung
Lung Neoplasms
Neoplasm Metastasis
Piperidines
Quadriplegia
Respiratory Insufficiency
Seizures
Analgesics
Dexmedetomidine
Hypnotics and Sedatives
Piperidines