A Case of Rhabdomyolysis Occurring during Surgery in Park-Bench Position

Abstract

A 72-year-old man （166 cm, 80 kg, BMI 29 kg/m 2 ） underwent removal of a left acoustic neurinoma in park-bench position. He was under a treatment for diabetes and hyperlipidemia. Four hours after taking the position, tea-colored urine appeared. His vital signs were stable without high fever, muscle rigidity, or electrolyte abnormalities, so surgery was continued. Redness in the skin of the lateral chest was noted after surgery. Rhabdomyolysis was diagnosed by the elevation of creatine phosphokinase （7,563 IU/L） , myoglobinuria （87 ng/mL） , and diffuse swelling of the right transverse abdominal and lumbar muscles on the day after surgery. Kidney dysfunction was not observed during the perioperative period. In this case, the main cause of rhabdomyolysis is long-term surgery in park-bench position. However, there are several other risks involved such as dehydration by fluid restriction and mannitol use and obesity. Attention should be paid to hypotension, dehydration, and electrolyte imbalances in addition to the particular position. Early detection and management of rhabdomyolysis is crucial.