Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7917-7922
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7917
Transient involuntary movement disorder after spinal anesthesia: A case report
Giyoung Yun, Eunsoo Kim, Wangseok Do, Young-Hoon Jung, Hyun-Ju Lee, Yesul Kim
Giyoung Yun, Eunsoo Kim, Wangseok Do, Young-Hoon Jung, Hyun-Ju Lee, Yesul Kim, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Giyoung Yun, Eunsoo Kim, Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
Author contributions: Yun G reviewed the literature and contributed to manuscript drafting; Kim E reviewed the literature and contributed to manuscript drafting; Do W and Jung Y cared for the patient; Kim Y and Lee H reviewed the manuscript; all authors have read and approved the final version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eunsoo Kim, MD, PhD, Associate Professor, Doctor, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan 49241, South Korea. eunsookim@pusan.ac.kr
Received: April 16, 2021
Peer-review started: April 16, 2021
First decision: May 10, 2021
Revised: May 28, 2021
Accepted: July 26, 2021
Article in press: July 26, 2021
Published online: September 16, 2021
Processing time: 147 Days and 1 Hours
Abstract
BACKGROUND

Spinal anesthesia is commonly used for various surgeries. While many complications occur after induction of spinal anesthesia, involuntary movement is an extremely rare complication.

CASE SUMMARY

Herein, we report the case of a 54-year-old healthy male patient who experienced involuntary movements after intrathecal injection of local anesthetics. This patient had undergone metal implant removal surgery in both the lower extremities; 7 h after intrathecal hyperbaric bupivacaine administration, involuntary raising of the left leg began to occur every 2 min. When the movement disorder appeared, the patient was conscious and cooperative. No other specific symptoms were noted in the physical examination conducted immediately after the involuntary leg raising started; moreover, the patient's motor and sensory assessments were normal. The symptom gradually subsided. Twelve hours after the symptom first occurred, its frequency decreased to approximately once every three hours. Two days postoperatively, the symptoms had completely disappeared without intervention.

CONCLUSION

Anesthesiologists should be aware that movement disorders can occur after spinal anesthesia and be able to identify the cause, such as electrolyte imbalance or epilepsy, since immediate action may be required for treatment. Furthermore, it is crucial to know that involuntary movement that develop following spinal anesthesia is mostly self-limiting and may not require additional costly examinations.

Keywords: Movement disorder; Spinal anesthesia; Bupivacaine; Dexmedetomidine; Case report

Core Tip: Various movement disorders can occur after induction of neuraxial anesthesia, and anesthesiologists should be aware of these symptoms. Upon their appearance, diseases requiring emergent treatment should be identified first. Once these are excluded, the spinal myoclonus that develops following neuraxial blockade is usually self-limiting; therefore, additional costly tests may not be necessary.