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Idiosyncratic Reaction to Propofol After Hip Arthroscopy

This case appears in the HSS publication, Grand Rounds from HSS - Management of Complex Cases, Summer 2012 - Volume 3, Issue 2, Case 3

Case 3, presented by William F. Urmey, MD, Associate Attending Anesthesiologist at Hospital for Special Surgery; Bryan T. Kelly, MD, Co-Director, Center for Hip Preservation and Associate Attending Orthopaedic Surgeon at Hospital for Special Surgery; Mandip Singh Kalsi, MD, Anesthesiology Fellow at Hospital for Special Surgery and Travis G. Maak, MD, Orthopaedic Surgery Fellow in Sports Medicine and Shoulder Service at Hospital for Special Surgery describes a 19-year-old female collegiate sprinter who presented with the chief complaint of right hip pain. The location of the pain was anterior, groin, and posterior; with no mechanical symptoms. She was able to walk on level ground approximately 10 minutes without pain. Physical therapy and various chiropractic manipulations had resulted in no change in symptoms. Subsequent evaluation revealed physical findings consistent with a labral tear in the right hip which was confirmed on Magnetic Resonance Imaging. Arthroscopic evaluation and treatment was proposed, subsequent to which a propofol neuroexcitatory reaction was discovered and identified.

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