Pain management and clinical considerations of a rare case of rhabdomyolysis caused by a hyperextension position after open radical cystectomy

Abstract

Compartment syndrome (CS) is caused by an excessive increase in compartment intramuscular pressure, in which measurement is the reference diagnostic tool. We examine the case of a 44-year-old man with invasive bladder cancer who underwent an open radical cystectomy. After extubation, the patient is transferred from the operating room to the intermediate care unit, where he complains of severe lumbar pain on a visual analog scale of 10 that is unresponsive to opioids and is diagnosed with rhabdomyolysis due to CS. Multidisciplinary care and multi-modal analgesia approaches were used; no fasciotomy was performed; and a favorable outcome was achieved.

Keywords

• Cystectomy complications. Post-operative pain. Post-operative hyperkalemia. Severe muscular pain. Surgery position complications. Compartment syndrome.