Tongue laceration in a patient taking antiplatelet agents during transcranial motor-evoked potential monitoring: a case report

JA Clinical Reports

Case Report

Hideyuki Nakagawa¹  Katsuhiro Matsumoto¹  Akira Kitamura¹ 

[1] Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, 350-1298, Saitama, Japan;

关键词: Motor-evoked potential;    Tongue bite injury;    Carotid endarterectomy;    Antiplatelet agent;   

DOI  :  10.1186/s40981-022-00593-6

 received in 2022-10-23, accepted in 2022-12-25,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTranscranial motor-evoked potential (Tc-MEP) monitoring is usually performed during surgeries involving a risk of damaging brain motor areas. However, it involves a risk of bite injuries. We report a case of severe tongue laceration from Tc-MEP stimulation during carotid endarterectomy (CEA) in a patient taking antiplatelet agents.Case presentationA 74-year-old man on antiplatelet therapy was scheduled for CEA under general anesthesia with intraoperative Tc-MEP monitoring. Bite blocks were not inserted. Postoperatively, we observed a tongue laceration with severe bleeding, which was sutured. The difficulties in tongue movement persisted for ≥ 1 month postoperatively.ConclusionsBite injuries during Tc-MEP may induce severe bleeding in patients on antiplatelets. The complications of tongue bite injuries may persist, decreasing the patients’ quality of life. Hence, during Tc-MEP monitoring, it is important to use soft bite blocks and to check the patient’s face and the position of the tracheal tube intraoperatively.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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