Case of the Month #59 A case of unexplained postoperative unresponsiveness

Published 18/12/2025

What initial investigations would you consider?

Initial Workup Should Include: 

  • Full A-E assessment and a comprehensive neurological examination
  • Review of intraoperative anaesthetic record
  • Neuromuscular monitoring and Neuromuscular drug reversal assessment
  • ABG, blood glucose, and electrolytes
  • 12 lead ECG 

 

Examination of the patient showed a mottled skin rash on the extremities and the trunk.  Also, the tongue was noticed to be abnormally pale. 

  

ABG and blood investigations were not significantly deranged. Train of four monitoring revealed no fade and pointed towards complete neuromuscular recovery. ECG showed normal sinus rhythm.