Bilateral thigh and calf compartment syndromes are rare in pediatric patients, especially following elective foot surgery. Such a case in a child with attention deficit hyperactivity disorder is described in the present report. This child was taking multiple medications, including Ritalin (methylphenidate hydrochloride), Paxil (paroxetine hydrochloride) and clonidine. Other factors that potentially contribute to the multiple compartment syndromes include pneumatic tourniquet use and caudal block augmentation of general anesthesia. Behaviour associated with attention deficit hyperactivity disorder complicated the detection of the patient's compartment syndromes. The development of the compartment syndromes was delayed more than 48 h on one side. The potential for this patient's pharmacotherapy to have contributed to the development of the compartment syndromes is discussed.
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