Abstract
A 60-year-old woman with quadriplegia due to chronic high spinal cord injury was scheduled for cholecystectomy under general anesthesia. Anesthesia was maintained with propofol and remifentanil. Autonomic hyperreflexia with severe hypertension and bradycardia was seen immediately after the operation. We increased the dose of remifentanil in order to control the hypertension, and the systemic blood pressure was normalized gradually. But the maintenance of the blood pressure with remifentanil during surgery was difficult for this patient. Further studies are needed to decide the appropriate dose of remifentanil to control and prevent severe hypertension.
