History conflict and non-formulary medicine: a threat for anaesthesiologist in low and middle-income countries

BMJ Case Rep. 2018 Aug 29:2018:bcr2017224141. doi: 10.1136/bcr-2017-224141.

Abstract

The practice of complementary and non-formulary medicine has gained tremendous popularity due to their claimed beneficial effects in cardiac, respiratory and chronic diseases, as also other disorders. The most threatening aspect related to these practices pertains to the non-disclosure of its use by patients at the time of their preoperative assessment in elective or emergency setting. We report a case of profound, long-lasting unexplained hypotension during and after anaesthesia in a patient presented for emergency vocal cord surgery (cordectomy). He was taking complementary medicine for last 2 years. Serum cortisol level was sent postoperatively in intensive care unit that was found extremely low.

Keywords: adult intensive care; anaesthesia; public health; safety.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Insufficiency / chemically induced
  • Adrenal Insufficiency / diagnosis*
  • Anesthesiology
  • Diagnosis, Differential
  • Humans
  • Male
  • Medicine, East Asian Traditional / adverse effects*
  • Middle Aged
  • Pakistan
  • Postoperative Complications / diagnosis
  • Preoperative Care
  • Respiratory Distress Syndrome / etiology
  • Vocal Cord Dysfunction / complications
  • Vocal Cord Dysfunction / surgery*