Masui. The Japanese journal of anesthesiology
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Neurological complications related to spinal anesthesia are exceptional, but their consequences are serious. We report a case of conversion disorder, which was initially diagnosed as monoplegia caused by spinal anesthesia. The patient was a 36-year-old, 88 kg woman with a history of psychogenic aphonia. ⋯ The reflexes and muscle's tonus were normal and EMG gave normal findings. The result of neurological diagnosis, confirmed the diagnosis of conversion disorder causing her monoplegia because she was under psychic stressful circumstances from her family. Conversion disorder as a cause of monoplegia after surgery under spinal anesthesia should be kept in mind.
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Although peripartum cardiac arrest is rare, the prognosis of the event may be worse than in nonpregnant patients because the events is often associated with pulmonary or amniotic embolisms. The following report is a case of cardiac arrest which occurred at the induction of anesthesia for the postpartum hysterectomy. A 31-year-old woman was treated with infusion of ritodrine chloride for preterm labor and placenta previa. ⋯ Since she was not resuscitated with cardiac massage, we started intravenous epinephrine, electronic cardioversion, the percutaneous cardiopulmonary support and intra-aortic balloon pumping with epinephrine and dopamine infusions leading to a successfully outcome. In this case, we believe that the combination of propofol and suxamethonium had the most impact on producing the cardiac arrest. Therefore, the case emphasizes the potential danger of using these combination for patients who have been treated with ritodrine.