Delayed Anesthesia due to Heat Stroke Developing in an Elderly Patient
Muratani, T.
Masui. Japanese Journal of Anesthesiology 64(12): 1284-1285
2015
ISSN/ISBN: 0021-4892 PMID: 26790335 Document Number: 683490
We report a case of rhabdomyolysis caused by heat stroke leading to delayed surgery. An 83-year-old woman living by herself was found lying on the floor, approximately one hour after a fall, and then transferred. She was hospitalized for first degree heat stroke and a left humeral transcondylar fracture and scheduled to undergo surgery. Preoperative examinations revealed a high creatine phosphokinase (CPK) value of 3,956 IU · l(-1). She was diagnosed with rhabdomyolysis caused by heat stroke, and surgery was delayed. She underwent surgery later, and perioperative management was completed. More than 80% of deaths caused by heat stroke are elderly cases, due to both physical and environmental factors. Surgery and anesthesia with elevated blood CPK can cause acute renal disorder. There are no certain criteria for identifying acute renal disorder associated with blood CPK elevation, making this condition difficult to assess. In this case, however, perioperative management was safely performed. The number of elderly cases with heat stroke is tending to increase, and we should treat these patients carefully.