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- Kumiko Chino, Jeffrey M Carness, Osorio Claudio, Matthew Haldeman, and Makoto Ozaki.
- From the Department of Anesthesiology, United States Naval Hospital, Yokosuka, Japan.
- A A Pract. 2021 May 6; 15 (5): e01448e01448.
AbstractA 22-year-old man, with a medical history significant for posttraumatic stress disorder and chronic pain, underwent ankle surgery at the United States Naval Hospital, Yokosuka, Japan. His immediate postoperative course was complicated by episodic muscle rigidity, necessitating admission for diagnostic evaluation. The differential was necessarily broad and included local anesthetic toxicity, medication mediated effect, seizures, serotonin syndrome, and malignant hyperthermia. Cultural and systemic differences in patient care delivery at a Japanese hospital helped to elucidate the mechanism. This case highlights cultural differences in pain management and navigates the differential of an acute onset movement disorder in the immediate postoperative period.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society.
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