Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Korean J Anesthesiol. 2010 Sep;59(3):210-3. doi: 10.4097/kjae.2010.59.3.210. Epub 2010 Sep 20.
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.
转换障碍的特征是躯体化和情绪困扰等心理症状，但大脑中没有异常电信号。我们报告了一例全身麻醉诱导期出现转换障碍的患者。一名 45 岁女性拟行膝关节镜半月板切除术。在手术室，她的情况稳定，但在这种情况下，她表现得非常紧张。在注射异丙酚诱导麻醉之前，我们先静脉注射 1%利多卡因 50mg 以缓解疼痛。注射后立即出现全身类似癫痫发作的活动，然后出现强直-僵硬性肌肉张力、伴有周期性呼吸的呼吸困难、意识混浊。手术被推迟，神经外科医生和精神科医生对她进行了检查。她被诊断为转换障碍，磁共振成像显示她的大脑没有异常。她在接受抗抑郁药物治疗和支持性心理治疗后病情好转。40 天后，她顺利地进行了膝关节手术。
