Perda visual conversiva em pós‐operatório de cirurgia de coluna: relato de caso

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dc.contributor.authorBezerra, Dailson Mamede [UNESP]
dc.contributor.authorBezerra, Eglantine Mamede
dc.contributor.authorSilva Junior, Antonio Jorge
dc.contributor.authorAmorim, Marco Aurélio Soares
dc.contributor.authorMiranda, Denismar Borges de
dc.contributor.institutionCentro de Ensino e Treinamento Dr. José Quinan
dc.contributor.institutionDefesa Profissional da Sociedade de Anestesiologia do Estado de Goiás (2015/2016)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionServiço de Anestesiologia
dc.contributor.institutionPontifícia Universidade Católica de Goiás (PUC/GO)
dc.contributor.institutionUniversidade Federal de Goiás (UFG)
dc.date.accessioned2018-12-11T16:40:48Z
dc.date.available2018-12-11T16:40:48Z
dc.date.issued2018-01-01
dc.description.abstractBackground and objective Patients undergoing spinal surgeries may develop postoperative visual loss. We present a case of total bilateral visual loss in a patient who, despite having clinical and surgical risk factors for organic lesion, evolved with visual disturbance due to conversion disorder. Case report A male patient, 39 years old, 71 kg, 1.72 m, ASA I, admitted to undergo fusion and discectomy at L4‐L5 and L5‐S1. Venoclysis, cardioscopy, oximetry, NIBP; induction with remifentanil, propofol and rocuronium; intubation with ETT (8.0 mm) followed by capnography and urinary catheterization for diuresis. Maintenance with full target‐controlled intravenous anesthesia. During fixation and laminectomy, the patient developed severe bleeding and hypovolemic shock. After 30 minutes, hemostasis and hemodynamic stability was achieved with infusion of norepinephrine, volume expansion, and blood products. In the ICU, the patient developed mental confusion, weakness in the limbs, and bilateral visual loss. It was not possible to identify clinical, laboratory or image findings of organic lesion. He evolved with episodes of anxiety, emotional lability, and language impairment; the hypothesis of conversion syndrome with visual component was raised after psychiatric evaluation. The patient had complete resolution of symptoms after visual education and introduction of low doses of antipsychotic, antidepressant, and benzodiazepine. Other symptoms also regressed, and the patient was discharged 12 days after surgery. After 60 days, the patient had no more symptoms. Conclusions Conversion disorders may have different signs and symptoms of non‐organic origin, including visual component. It is noteworthy that the occurrence of this type of visual dysfunction in the postoperative period of spinal surgery is a rare event and should be remembered as a differential diagnosis.en
dc.description.affiliationCentro de Ensino e Treinamento Dr. José Quinan
dc.description.affiliationDefesa Profissional da Sociedade de Anestesiologia do Estado de Goiás (2015/2016)
dc.description.affiliationUniversidade Estadual Paulista Júlio de Mesquita Filho (FMB/Unesp) Faculdade de Medicina
dc.description.affiliationHospital Adventista de Belém Serviço de Anestesiologia
dc.description.affiliationPontifícia Universidade Católica de Goiás (PUC/GO)
dc.description.affiliationUniversidade Federal de Goiás (UFG)
dc.description.affiliationUnespUniversidade Estadual Paulista Júlio de Mesquita Filho (FMB/Unesp) Faculdade de Medicina
dc.format.extent91-95
dc.identifierhttp://dx.doi.org/10.1016/j.bjan.2015.03.004
dc.identifier.citationBrazilian Journal of Anesthesiology, v. 68, n. 1, p. 91-95, 2018.
dc.identifier.doi10.1016/j.bjan.2015.03.004
dc.identifier.file2-s2.0-84955507950.pdf
dc.identifier.issn1806-907X
dc.identifier.issn0034-7094
dc.identifier.scopus2-s2.0-84955507950
dc.identifier.urihttp://hdl.handle.net/11449/168328
dc.language.isoeng
dc.language.isopor
dc.relation.ispartofBrazilian Journal of Anesthesiology
dc.relation.ispartofsjr0,320
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectBlindness
dc.subjectConversion disorder
dc.subjectDecubitus ventral
dc.subjectGeneral anesthesia
dc.subjectLaminectomy
dc.titlePerda visual conversiva em pós‐operatório de cirurgia de coluna: relato de casopt
dc.title.alternativePostoperative visual loss due to conversion disorder after spine surgery: a case reporten
dc.typeArtigo

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