Rhabdomyolysis: another complication after prolonged surgery

We present the case of a young patient who underwent a prolonged urological procedure in the lateral decubitus position. The patient's postoperative course was complicated by rhabdomyolysis manifested by elevated levels of serum creatine phosphokinase and the presence of myoglobin in urine and blood. To prevent renal failure, we managed the patient in the intensive care unit with generous volumes of intravenous fluids, forced diuresis, and urine alkalization. Subsequently, the patient had an uneventful recovery. The linkage between surgical positioning, prolonged surgery time, and rhabdomyolysis is discussed. (C) 2007 Elsevier Inc. All rights reserved.