Perioperative Autonomic Dysreflexia


  • Filipa Lagarto Serviço de Anestesiologia - Centro Hospitalar do Porto
  • Pedro Pina Serviço de Anestesiologia - Centro Hospitalar do Porto



disreflexia autonómica, lesão vértebro-medular, cirurgia urológica, hipertensão, anestesia geral, bloqueio sub-aracnoideu


Autonomic dysreflexia is characterized by an uncontrolled sympathetic response in patients with spinal cord injury at or above the sixth thoracic vertebral level, mainly caused by noxius and non-noxius stimulus below the level of injury,. The authors report the case of a 48-year-old woman with spinal cord injury at the level of the cervicothoracic junction submitted to intravesical botulinum toxin injection under inhaled general anesthesia. Intraoperatively the patient developed bradycardia, sustained hypertension (maximum arterial blood pressure 184/121 mmHg) and flushing of the neck and thorax, suggestive of autonomic dysreflexia. Despite fast diagnosis and removal of precipitating factors, symptoms only reverted postoperatively following administration of labetalol. This report aims to highlight the importance of preventive measures, namely the use of regional anesthesia for urologic surgery in patients with spinal cord injury. 


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How to Cite

Lagarto, F., & Pina, P. (2016). Perioperative Autonomic Dysreflexia. Journal of the Portuguese Society of Anesthesiology, 25(2), 69–72.