Abstract
We report on difficulties encountered in the post-surgical management of a mandibular gingival carcinoma patient experiencing post-operative psychiatric disorder.
The 56- year-old man had received a partial mandiblectomy with radical neck dissection and reconstruction by major pectoralis myocutanous flap under general NLA anesthesia. The post-operative psychiatric symptoms of insomnia, removal of own catheters and tubes, excitation, delusion, the attempted self-injection of medication into a vein, and prowling were observed two days after surgery. No psychiatric disorder was evident after the removal of all catheters and tubes, and there was no recurrence.
This patient had some risk factors for postoperative psychiatric disorder: insomnia, a long operation, many catheters and tubes, stubbornness, alcohol withdrawal etc.
We suggest that it is very important to evaluate such diverse risk factors for each patient pre-operatively in order to prepare in an appropriate manner for the occurrence of post-operative psychiatric disorders.
