Hemodynamic Response to Massive Bleeding in a Patient with Congenital Insensitivity to Pain with Anhidrosis.
Yuki SugiyamaSayako GotohMasatoshi UrasawaMikito KawamataKoichi NakajimaPublished in: Case reports in anesthesiology (2018)
A patient with congenital insensitivity to pain with anhidrosis (CIPA) underwent revision of total hip arthroplasty under general anesthesia with only propofol. During surgery, neither elevation of stress hormones nor hemodynamic changes associated with pain occurred; however, when blood was rapidly lost, compensatory tachycardia was observed. Although patients with CIPA are complicated with autonomic disturbance due to dysfunction of postganglionic sympathetic fibers, this compensatory response indicated that the adrenal glands in patients with CIPA secrete catecholamine as part of a compensatory response during bleeding under general anesthesia.
Keyphrases
- chronic pain
- total hip arthroplasty
- pain management
- neuropathic pain
- case report
- minimally invasive
- atrial fibrillation
- total knee arthroplasty
- oxidative stress
- heart rate variability
- spinal cord injury
- heart rate
- blood pressure
- spinal cord
- percutaneous coronary intervention
- postoperative pain
- heat stress
- surgical site infection