CEREBRAL COMPLICATIONS OF HYPOTENSIVE ANAESTHESIA IN A HEALTHY ADULT

The psychiatric, neurological, and pathological sequelae of a plastic operation carried out under drug-induced hypotension in a healthy, normotensive woman of 43 years who died 23 months later are presented.

Abstract

The employment of deliberately induced hypo- tension with the purpose of reducing haemorrhage or oedema is a procedure that does not yet receive the unequivocal endorsement of all anaesthetists and surgeons.The inherent risk is that of ischaemia in vital organs.This report presents the psychiatric, neurological, and pathological sequelae of a plastic operation (mammaplasty) carried out under drug-induced hypotension in a healthy, normotensive woman of 43 years who died 23 months later.The return of consciousness was delayed, and the patient showed an organic dementia characterized by a Korsakoff psychosis and also some permanent Parkinsonian features. CASE REPORTThe patient was a previously healthy woman aged 43, who underwent a bilateral Beisenberger mammaplasty for cosmetic reasons.Physical examination before the operation showed no abnormalities and her blood pres- sure was recorded as 130/90 mm.Hg.OPERATION Anaesthesia was induced by Pentothal 430 mg., Flaxedil 80 mg., and Arfonad 50 mg.This was followed by Pentothal 500 mg.and Flaxedil 40 mg., in split doses, plus nitrous oxide and oxygen.The patient was put into a position of about 200 head-up tilt, and Protected by copyright.