Prolonged effect of nicardipine used for deliberate hypotension in scoliosis surgery: A case report

Oh, Sae Cheol; Chung, Kyudon; Cho, Hyun Sook; Ryu, Keon Hee; Cho, Sung Ah; Lee, Sang Mook

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2010;5(4):317-320.
Published online October 31, 2010.

Prolonged effect of nicardipine used for deliberate hypotension in scoliosis surgery: A case report

Sae Cheol Oh, Kyudon Chung, Hyun Sook Cho, Keon Hee Ryu, Sung Ah Cho, Sang Mook Lee

Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. ismoogi@catholic.ac.kr

Abstract

Postoperative respiratory complications following scoliosis surgery are high incidence. In this case, fifty year-old male patient was admitted for thoracolumbar screw fixations and developed postoperative pulmonary edema. This was most likely due to prolonged administration of nicardipine, which over time may inadvertently cause hypotension. As a result of volume overload, interstitial pulmonary edema and pleural effusion occurred. Moreover, pulmonary edema and pleural effusion appeared on the right side first and spread to the left. This phenomenon could be explained by the positioning of scoliosis patient. The cause of pulmonary edema was volume overload initiated by prolonged effect of nicardipine.

Key Words: Deliberate hypotension, Nicardipine, Postoperative complication, Scoliosis