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Visual hallucinations on eye closure after orthopedic surgery under general anesthesia

Authors
  • Otomo, Sumi1
  • Sugita, Michiko2
  • Yano, Toshiyuki3
  • 1 Kumamoto Chuo Hospital, Department of Anesthesiology, Kumamoto, Japan , Kumamoto (Japan)
  • 2 Kumamoto University Hospital, Department of Anesthesiology, Kumamoto, Japan , Kumamoto (Japan)
  • 3 Kumamoto Kinoh Hospital, Division of Anesthesia, 6-8-1 Yamamuro, Kumamoto, 860-8518, Japan , Kumamoto (Japan)
Type
Published Article
Journal
Journal of Anesthesia
Publisher
Springer Japan
Publication Date
Nov 15, 2008
Volume
22
Issue
4
Pages
439–442
Identifiers
DOI: 10.1007/s00540-008-0665-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

A 61-year-old woman suffering from rheumatoid arthritis without a contributory neurological, mental, or psychological history experienced visual hallucinations solely on eye closure after total hip arthroplasty under general anesthesia combined with epidural anesthesia. The visual hallucinations first appeared when she arose from sleep early on postoperative day 1, approximately 12 h after the end of surgery. Only on closing her eyes, she had a clear view of colored clothes, lace curtains, handbags, hats, and sofas, all of which were vivid, realistic, complex, of natural size, and in normal perspective without distortion and appeared independently and randomly in succession. The hallucinations disappeared when she opened her eyes even in the dark. The visual hallucinations gradually decreased as the days elapsed and they had entirely subsided on postoperative day 4. The level and content of her consciousness seemed entirely normal throughout her hospital course. Although postoperative visual hallucinations are not uncommon, they do not always show the closed-eye variation. The causes and underlying mechanisms of this type of visual hallucination remain to be elucidated.

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