全身麻酔後に呼吸困難を呈し身体表現性障害が疑われた1症例

A Case of Suspicious Somatoform Disorder after Repair of Inguinal Hernia under General Anesthesia

要旨

　全身麻酔後に呼吸困難などの症状を認め，身体表現性障害が疑われた症例を経験した。中年期男性における，術後の身体表現性障害は過去に例を見ないが，術後に呼吸困難を来した際は，麻酔薬の残存，内科的疾患を除外のうえで，身体表現性障害の可能性を念頭に置き，早期から精神科診察を含め集学的に対応すべきである。

　A 61-year-old man was scheduled for laparoscopic inguinal hernia repair under general anesthesia with regional anesthesia. An hour after the surgery, since he complained of dyspnea, he was administered naloxone and sugammadex accompanied with manual assist ventilation. As a result, his symptoms gradually improved. However, on the following day the respiratory symptoms recurred and the patient required intubation. Neurological consultation and investigations ruled out that the patient have had neurological disorder. In the meanwhile, the interview revealed his past avoidance behaviors at workplace. Consequently, he was suspected to have somatoform disorder due to psychological stress related to the surgery and anesthesia.