Serotonin Syndrome in the Perioperative Setting

The American Journal of Case Reports
Nathan J SmischneyOludare O Olatoye

Abstract

BACKGROUND Serotonin syndrome is a life-threatening condition that can lead to neurologic complications and is associated with the use of serotonergic medications. As the use of antidepressant medications has increased, the incidence of perioperative serotonin syndrome has transitioned from a rare diagnosis to one that should be considered as a differential diagnosis for any patient displaying signs of neuroexcitation. CASE REPORT A 70-year-old man (ASA 2) with a history of vestibular migraines (treated with venlafaxine), gastroesophageal reflux disease, and benign prostatic hyperplasia presented to our institution for photoselective vaporization of the prostate. Upon review of prior anesthetic records, his medical chart was found to list a propofol allergy. In discussion with the patient, he stated the reaction was rigidity. The anesthesiologist and patient agreed this was not an allergy. Thus, the patient was induced with propofol and given ketamine and fentanyl boluses throughout the procedure. During emergence, the patient exhibited myoclonic jerks in the upper and lower extremities. He was given intravenous meperidine for postoperative shivering; minutes after administration, the myoclonic jerks and rigidity worsened. The ...Continue Reading

Citations

Oct 3, 2019·A&A Practice·Mary E WarnerMark A Warner
Oct 3, 2020·The Neurodiagnostic Journal·Otakhon Matchanov, Priscilla Nelson
Jan 21, 2020·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Edwin N ArokeBryan A Wilbanks
Apr 29, 2021·Journal of Child and Adolescent Psychopharmacology·Lisa HutchisonYehuda Lerea
Oct 4, 2020·The American Journal of Emergency Medicine·Sanjay Prakash
Nov 23, 2021·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Angela L Chiew, Nicholas A Buckley

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