Campbell John P, Soelberg Cobin, Lauer Andreas K
Retina Division, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA.
Clin Ophthalmol. 2013;7:1557-8. doi: 10.2147/OPTH.S48353. Epub 2013 Aug 1.
Rhabdomyolysis is a known, but rare, complication of general anesthesia. To the authors' knowledge, it has never before been reported following an ocular surgery, and we could find no similar cases in the surgical literature following any brief surgical procedure. We believe this case to be unique in those regards and aim to raise awareness among ophthalmologists of this postoperative complication, as timely intervention can prevent renal failure and death.
We report the case of a 58-year-old male who developed rhabdomyolysis following vitrectomy for retinal detachment repair under general anesthesia. The patient had several risk factors for this complication including morbid obesity, type II diabetes mellitus, and American Society of Anesthesia class III risk profile. His postoperative course was notable for significant myalgias in the postoperative recovery area, followed several hours later by oliguria, "root beer" colored urine, and a markedly elevated creatinine kinase level. He was hospitalized for two days for intravenous hydration and monitoring of his renal function and has fully recovered.
As the prevalence of obesity and type II diabetes mellitus increase worldwide, ophthalmologists need to be aware of the signs and symptoms of postoperative rhabdomyolysis. Treatment often requires inpatient hospitalization to prevent the associated morbidity and mortality.
横纹肌溶解是全身麻醉已知但罕见的并发症。据作者所知，此前从未有过眼科手术后发生横纹肌溶解的报道，而且在任何简短手术操作后的外科文献中我们也未发现类似病例。我们认为该病例在这些方面具有独特性，旨在提高眼科医生对这种术后并发症的认识，因为及时干预可预防肾衰竭和死亡。
我们报告一例58岁男性病例，该患者在全身麻醉下行玻璃体切除术修复视网膜脱离后发生横纹肌溶解。该患者存在多种导致此并发症的危险因素，包括病态肥胖、II型糖尿病以及美国麻醉医师协会III级风险分级。其术后病程特点为在术后恢复区出现明显肌痛，数小时后出现少尿、“根啤”色尿液以及肌酸激酶水平显著升高。他因静脉补液及监测肾功能住院两天，现已完全康复。
随着全球肥胖症和II型糖尿病患病率的增加，眼科医生需要了解术后横纹肌溶解的体征和症状。治疗通常需要住院以预防相关的发病率和死亡率。
