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Asian J Pain > Volume 4(1); 2018 > Article
Asian Journal of Pain 2018;4(1):16-18.
DOI: https://doi.org/10.35353/ajp.4.1.16    Published online May 30, 2018.
Management of Postprandial Hypotension in a Tetraplegic Patient after Cervical Spinal Cord Injury
Yong-Jun Lee, Sang-Hyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Correspondence:  Tae-Ahn Jahng, Tel: +82-31-787-7164, Fax: +82-31-787-4059, 
Email: taj@snu.ac.kr
Abstract
Our aim was to present a case of postprandial hypotension in a tetraplegic patient with a cercal spinal cord lesion. A 43-year-old woman presented in the emergency room with tetraplegia after a motor vehicle crash. Radiologic studies showed dislocation at the C4–C5 level. Promptly, under general anesthesia, she underwent closed reduction, anterior cervical discectomy, and fusion at the C4–C5 level for stabilization. From the second day postoperatively, her systolic blood pressure was reduced from 120–150 mmHg to 40–60 mmHg when she made a positional change or after she ate. We tried administering a very slow and continuous infusion rate of a liquid meal (60 cc/h), and it was very effective in controlling PPH. In rare cases of PPH in a tetraplegic patient with a cervical spinal cord lesion, a very slow and continuous infusion rate of a liquid meal (60 cc/h) may be one effective management method.
Key Words: Tetraplegia; Hypotension; Feeding methods
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