Meningismus after metaraminol administration in a patient with Familial Mediterranean fever.

摘要

A 38-yr-old male was admitted to our hospital for treatment of Familial Mediterranean fever (FMF)-related severe episodic abdominal pain. Familial Mediterranean fever is a hereditary inflammatory disease characterized by self-limited recurrent attacks of fever and serositis; the recurrent attacks of fever are accompanied by severe abdominal pain, arthritis and/or chest pain along with a marked increase in acute phase reactants.1 It was decided to implant a spinal cord stimulator (SCS) for pain control because of inadequate pain relief despite high-dose opioid therapy. Following the epidural placement and positioning of the SCS leads under local anesthesia, general anesthesia was administered for sc implantation of the pulse generator. The patient developed hypotension during the course of the anesthetic and this was corrected with fluids and intermittent iv metaraminol boluses (cumulative dose: 10 mg). The procedure was completed uneventfully and the patient awakened.