A 50-year-old man with a complete medullary section at the old C6-C7 level and suspicion of autonomic hyperreflexia (HA) was assumed to benefit from cystectomy with Bricker-type non-continent urinary diversion. In addition to general anesthesia, thoracic epidural analgesia and intravenous lidocaine were used to prevent HA during the operative period, facilitating postoperative rehabilitation. The patient remained stable throughout the procedure, without any major problems postoperatively. Oral feeding was started on Day 3. The article describes the benefits of epidural analgesia and intravenous lidocaine for managing patients at risk for HA.
Key Words
Medullary injury, anesthesia, autonomic hyperreflexia, peridural, lidocain