1/4. Gluteal compartment syndrome after prostatectomy caused by incorrect positioning.Gluteal compartment syndrome is an uncommon and rare disease. Most reasonable causes for the development of this disease are trauma, drug induced coma, ehlers-danlos syndrome, sickle cell associated muscle infarction, incorrect positioning during surgical procedures and prolonged pressure in patients with altered consciousness levels. The diagnosis requires a high index of suspicion, especially in postoperative patient where sedation or peridural anaesthesia can confound the neurological examination. Early signs include gluteal tenderness, decrease in vibratory sensation during clinical examination and increasing CK in laboratory findings. We present a case of a 52 year-old patient, who developed gluteal compartment syndrome after radical prostatectomy in lithotomic position. After operation, diuresis decreased [<50 ml/h] and CK [93927 U/l], LDH [1528 U/l], creatinin [1.5 mg/dl] and urea [20 mg/dl] increased in laboratory findings. Despite peridural anaesthesia, the patient complained about increasing pain in the gluteal region and both thighs. His thighs and the gluteal region were swollen. Passive stretch of the thighs caused enormous pain. The compartment pressure was 92 mmHg. Therefore, emergency fasciotomy was performed successfully. The gluteal compartment syndrome was most likely caused by elevated pressure on the gluteal muscle during operation. We suggest heightened awareness of positioning the patient on the operating table is important especially in obese patients with lengthy operating procedures.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/4. Haematoma block for fractures of the wrist: a cause of compartment syndrome.A case of compartment syndrome after haematoma block for a fracture of the distal radius is reported. This seems to be the first report of this complication. A review of the literature revealed seven other cases of compartmental ischaemia reported after fracture of the distal radius, and a haematoma block was used in all the cases where the type of anaesthesia was known. It is suggested that the additional fluid added for a haematoma block can precipitate a compartment syndrome, which may be more common than the scarcity of cases reported would indicate.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
3/4. Upper limb compartment syndromes: a complication of malignant hyperthermia in a patient with ill-defined myopathy.We report a case of compartment syndrome complicating malignant hyperthermia (MH) in a 12-yr-old girl with a history of myopathy and multiple skeletal deformities; she underwent bilateral achilles tendon surgery. Marked oedema of both forearms became evident in the immediate postoperative period and resolved after conservative treatment. Compartment syndrome is a rare complication of MH. Early recognition and therapy may prevent the onset of muscle ischaemia and distal neurovascular deficit. The need for urgent surgery and repeated anaesthesia in the early phase of recovery from an acute episode of MH may thus be reduced.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/4. Compartment syndrome as a complication of the prolonged use of the Lloyd-Davies position.Compartment syndrome in the legs is a rare complication of the prolonged use of the lithotomy position. We report two cases of compartment syndrome developing as a complication of the prolonged use of the Lloyd-Davies position. Both patients received combined general and epidural anaesthesia and postoperative epidural analgesia. The diagnosis was delayed in the first case, resulting in the avoidable complications of renal failure and permanent neuromuscular dysfunction.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |