[Anesthetic management of a patient with chronic high spinal cord injury (second report)]

We administered anesthesia twice to a 43-year-old male patient with complete sensory and motor disturbance below the upper thoracic nerves due to chronic high spinal cord injury. The first operation was the gluteus maximus musculocutaneous flap for closure of a sacral decubitus ulcer under general anesthesia. The second was the transurethral lithotripsy for the bladder stone under spinal anesthesia. Severe hypertension occurred probably due to autonomic hyperreflexia (AH) during both operations. Therefore, we must be careful in anesthetic management of patients with chronic high spinal cord injury, because AH might occur in any anesthetic administration.