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Papers of the Week

2021 May 06

A A Pract



Unrecognized Postoperative Opioid-Induced Movement Disorder: A Case Report.


Chino K, Carness JM, Claudio O, Haldeman M, Ozaki M
A A Pract. 2021 May 06; 15(5):e01448.
PMID: 33955857.


A 22-year-old man, with a medical history significant for posttraumatic stress disorder and chronic pain, underwent ankle surgery at the United States Naval Hospital, Yokosuka, Japan. His immediate postoperative course was complicated by episodic muscle rigidity, necessitating admission for diagnostic evaluation. The differential was necessarily broad and included local anesthetic toxicity, medication mediated effect, seizures, serotonin syndrome, and malignant hyperthermia. Cultural and systemic differences in patient care delivery at a Japanese hospital helped to elucidate the mechanism. This case highlights cultural differences in pain management and navigates the differential of an acute onset movement disorder in the immediate postoperative period.