Anesthesiology/Query

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Question
Dear Doctor,

My mother 62 years old suffering from Spasmodic Torticollis (ST). She has stone in gallbladder need laparoscopic surgery. For this she need local anesthesia.

Now my question is, is their any possibilities to not coming her sense due to Spasmodic Torticollis (ST) problem.

Please let us know and make us worry free.

Thanks in advance

Regards
Niaz

Answer
Niaz,

My apologies for taking so long to get to your question.  I thank you for taking the time to ask your question.  I'll do my best to answer you.

I have to admit, I'm a little confused with your question.  You mention that your mother needs laparoscopic surgery for her gall bladder, and you also state she needs local anesthesia.  Are you referring to the injections they use when/where they put in the laparoscopic ports?

In my experience, and I am by no means an expert in Spasmodic Torticollis (ST), I have not come across any specific type of anesthesia that will elicit/bring on ST.  There have been a couple case reports of where ST occurred after induction of general anesthesia, and quickly resolved with diphenhydramine, due to what was thought as a dystonic reaction to possible patient daily medications (patient was schizophrenic and had suicidal ideations).  ST can also occur due to prolonged positioning of the head/neck, mostly in a side-laying position.  

That being said, and that ST is a physical limitation, it is unclear from your question, what you mean when you say "is there any possibilities to not coming her sense due to ST.)  Could you clarify?  Are you referring to her mentation?  Physical outcomes?

I will be happy to answer any further queries you might have, and I hope that I have helped in some degree.

Thanks again for the query-

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Dino Kattato MSNA CRNA

Expertise

Former ICU/ER RN with several years of experience. I can answer questions relating to the CRNA education process, professional issues involved, as well as questions about adult and pediatric clinical anesthesia.

Experience

Level I regional Trauma center dealing with simple to complex patient populations of all ages. Experience with general anesthesia, spinal and epidural anesthesia, and total IV anesthesia for all surgical specialties including neuro, ortho, general surgery, vascular, electrophysiology, and VIR, with the exception of cardiac anesthesia. Ambulatory surgery center dealing mostly with ENT, plastics, and eyes (70%:30% peds:adults).

Organizations
AANA NYSANA

Publications
AANA Journal February 2010 Feb;78(1):24-7. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Retrieve&list_uids=20977125&dopt=abstractplus

Education/Credentials
RN BSN MSNA ACLS/PALS BLS instructor

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