Korean J Anesthesiol.  2010 Sep;59(3):210-213. 10.4097/kjae.2010.59.3.210.

Conversion phenomenon during the induction period of general anesthesia: A case report

• Kim JS
• Cho EJ
• Park LJ
• O JS

• KMID: 2239780
• DOI: http://doi.org/10.4097/kjae.2010.59.3.210

Abstract

Conversion disorder is characterized as psychological symptoms such as somatization and emotional distress, but there is no abnormal electrical signal in the brain. We report a patient who appeared conversion disorder during the induction period of general anesthesia. A 45-year-old woman was planned for arthroscopic knee meniscectomy. In the operating room, she appeared stable, but she said extremely nervous in this situation. Before propofol injection for induction of anesthesia, we injected 1% lidocaine 50 mg iv for pain relief. Immediately after injection, she showed general seizure-like activity and then tonic-rigid muscle tone, dyspnea with periodic breathing without cyanosis, and clouding of consciousness. The operation was delayed, and she was examined by neurosurgeon and psychiatrist. She was diagnosed as suffering with conversion disorder and she was without brain abnormalities on the magnetic resonance imaging. Her condition improved after anti-depressant medication and supportive psychotherapy. She underwent uneventful knee surgery 40 days later.

Keyword

Anesthesia; Conversion; Distress; Psychotherapy

MeSH Terms

Anesthesia
Anesthesia, General
Brain
Consciousness
Conversion Disorder
Cyanosis
Dyspnea
Female
Humans
Knee
Lidocaine
Magnetic Resonance Imaging
Middle Aged
Muscles
Operating Rooms
Propofol
Psychiatry
Psychotherapy
Respiration
Stress, Psychological
Lidocaine
Propofol