Conversion phenomenon during the induction period of general anesthesia -A case report-

다국어 초록 (Multilingual Abstract)

Conversion disorder is characterized as psychological symptoms such as somatization and emotional distress, but there is no abnormal electrical signal in the brain. We report a patient who appeared conversion disorder during the induction period of general anesthesia. A 45-year-old woman was planned for arthroscopic knee meniscectomy. In the operating room, she appeared stable, but she said extremely nervous in this situation. Before propofol injection for induction of anesthesia, we injected 1% lidocaine 50 mg iv for pain relief. Immediately after injection, she showed general seizure-like activity and then tonic-rigid muscle tone, dyspnea with periodic breathing without cyanosis, and clouding of consciousness. The operation was delayed, and she was examined by neurosurgeon and psychiatrist.
She was diagnosed as suffering with conversion disorder and she was without brain abnormalities on the magnetic resonance imaging. Her condition improved after anti-depressant medication and supportive psychotherapy. She underwent uneventful knee surgery 40 days later.

참고문헌 (Reference)

1 최수주, "수술 전 마취와 관련된 환자의 불안과 관심에 대한 조사" 대한마취과학회 42 (42): 11-16, 2002

2 Macario A, "Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists" 88 : 1085-1091, 1999

3 Moerman N, "The amsterdam preoperative anxiety and information scale" 82 : 445-451, 1996

4 Hollifield MA, "Somatoform disorder. In: Comprehensive Textbook of Psychiatry" Lippincott Williams & Wilkins 1800-1818, 2005

5 De Witte JL, "Preoperative alprazolam reduces anxiety in ambulatory surgery patients: a comparison with oral midazolam" 95 : 1601-1606, 2002

6 Lindsay KW, "Neurology and neurosurgery illustrated" Bath Press 88-101, 1997

7 Dorf E, "Lidocaine-induced altered mental status and seizure after hematoma block" 31 : 251-253, 2006

8 Clarke JR, "Hysterical blindness during dental anaesthesia" 162 : 1987

9 Diaz Allegue M, "Epidural anesthesia in labor and conversion disorder" 56 : 312-314, 2009

10 Lee A, "Educating patients about anaesthesia: effect of various modes on patient’s knowledge, anxiety and satisfaction" 18 : 205-208, 2005

11 Haden RA, "Conversion reaction following anaesthesia" 59 : 728-729, 2004

12 Orr DL 2nd, "Conversion phenomenon following general anesthesia" 43 : 817-819, 1985

13 Schecker N, "Childhood conversion reactions in the emergency department: part II-general and specific features" 6 : 46-51, 1990

14 Yokoyama K, "A case of monoplegia from conversion disorder after spinal anesthesia" 51 : 1363-1367, 2002

15 Sugimoto Y, "A case of conversion disorder after spinal anesthesia" 58 : 209-211, 2009