Visual hallucinations on eye closure after orthopedic surgery under general anesthesia
Visual hallucinations on eye closure after orthopedic surgery under general anesthesia
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DOI：
10.1007/s00540-008-0665-8
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发表时间：
2008-11-01
影响因子：
2.8
通讯作者：
Yano, Toshiyuki
中科院分区：
文献类型：
--
作者：
Otomo, Sumi;Sugita, Michiko;Yano, Toshiyuki
一名61岁的女性，患有类风湿性关节炎，无神经、精神或心理病史，在全麻联合硬膜外麻醉下接受全髋关节置换术后，仅在闭眼时出现幻视。术后第1天，即手术结束后约12小时，患者从睡眠中醒来时首次出现幻视。只有闭上眼睛，她才能清楚地看到彩色的衣服、蕾丝窗帘、手袋、帽子和沙发，所有这些都是生动、逼真、复杂、自然的大小，在正常的视角下没有扭曲，独立而随机地相继出现。即使在黑暗中，当她睁开眼睛时，幻觉也消失了。随着时间的推移，幻视逐渐减少，并在术后第4天完全消退。在整个住院期间，她的意识水平和内容似乎完全正常。虽然术后幻视并不少见，但并不总是表现为闭眼变化。这种类型的幻视的原因和潜在机制仍有待阐明。
A 61-year-old woman suffering from rheumatoid arthritis without a contributory neurological, mental, or psychological history experienced visual hallucinations solely on eye closure after total hip arthroplasty under general anesthesia combined with epidural anesthesia. The visual hallucinations first appeared when she arose from sleep early on postoperative day 1, approximately 12 h after the end of surgery. Only on closing her eyes, she had a clear view of colored clothes, lace curtains, handbags, hats, and sofas, all of which were vivid, realistic, complex, of natural size, and in normal perspective without distortion and appeared independently and randomly in succession. The hallucinations disappeared when she opened her eyes even in the dark. The visual hallucinations gradually decreased as the days elapsed and they had entirely subsided on postoperative day 4. The level and content of her consciousness seemed entirely normal throughout her hospital course. Although postoperative visual hallucinations are not uncommon, they do not always show the closed-eye variation. The causes and underlying mechanisms of this type of visual hallucination remain to be elucidated.