[Case of autonomic hyperreflexia treated with intravenous nicardipine].

We describe a case of 26-year-old male patient with autonomic hyperreflexia (AH) during colostomy. He had suffered paraplegia due to the 8th cervical spinal cord injury by a traffic accident 2 years before. The anesthesia was induced and maintained with propofol, fentanyl, ketamine and vecuronium. Vital signs including blood pressure (135-145/70-80 mmHg) and heart rate (55-65 beats x min(-1)), were stable at the beginning of the operation. However, blood pressure suddenly rose (220/ 120mmHg), and heart rate decreased (43 beats x min(-1)) associated with skin eruptions on his face and shoulder when the intestinal tract procedure was started. Diagnosis of AH was made. Then nicardipine 1 mg i.v. was given followed by nicardipine 2 microg x kg(-1) x min(-1) DIV Consequently, blood pressure (140-155/ 70-85 mmHg) and heart rate (75-85 beats x min(-1)) were stabilized. The operation was finished with no evidence of any complications. Nicardipine may be preferable in a patient with upper spinal cord injury undergoing operation in the paralyzed area.