Abstract
Nöroleptik malign sendrom (NMS), nöroleptiklerle yapılan tedavinin nadir fakat oldukça letal bir komplikasyonudur. NMS, nöroleptik kullanımına bağlı, ciddi ekstrapramidal fonksiyon bozukluğu, hipertermi, bilinçte dalgalanmalar ve otonomik bozukluklar ile karakterize bir sendromdur. Bu makalede biz, anestezi sırasında haloperidol enjeksiyonunu takiben NMS gelişen bir hastayı sunuyoruz. Hastamızda genel anestezi tiyopental, süksinilkolin, N:0/0; ve halotan ile sağlanmıştır. NMS anestezinin verilmesinden sonra ortaya çıkmıştır. Tam, takikardi, hiperpine,
terleme, jeneralize kas rijiditesi, akinezi, hipertermi, bilincin açılmaması ve serum kreatin fosfokinaz (CPK) düzeyinin yükselmesine dayanarak konmuştur. Tedavi, soğutma, oksijen tedavisi, böbrek
yetmezliğini önlemek için volüm replasmanı ve diürezin zorlanmasından ibarettir. Özet olarak nöroleptikleri kullanan tıp ekibinin NMS'un gelişme olasılığı hakkında uyanık olması ve başarılı bir tedavi için erken tanı konulması gereklidir.
Project Number
-
References
- 1. Baldessarini RS : Drugs and the treatment of psychiatric disorders. In : Gilman AG, Goodmann LS, Rall TW, Murad F, eds. The pharmacological basis of therapeutics,7 th ed. New York, Mc Millan Pub 1985 : 387-445.
- 2. Britt BA, Kalow W : Malignant hyperthermia : A statistical review, Can Anaesth Soc J 17 : 293-315, 1970.
- 3. Burke RE, Fahn S, Mayeux R, Weinberg H, Louis K, Willner JH ; Neurolepticmalignant syndrome caused by dopamine-depleting drugs in a patient withHuntington disease, Neurology (Ny) 31 : 1022 1026, 1981.
- 4,Cremona-Barbaro A : Neuroleptic induced catatonic symptoms. Br J Psyohiairy 142 : 98-99, 1988.
- 5. Daoudal P, Delacour JL : Treatment of neuroleptic malignant syndrome with dantrolene. Lancet 2 : 217, 1982.
- 6.Dhib-Jalbut $, Hesselbrock R, Brott J, Silbergeld b : Treatment of ihe neuroleptic malignant syndrome with bromecriptine, JAMA 250 : 484-485
- 7. Fletcher JE, Rosenberg H, Lizzo FH ; Effects of droperidol, haloperidol and ketamine on halothane, succinylcholine, and caffeine contractures : implications or malignant hyperihermia. Acta Anaesthesiol Scand 33 : 187-192, 1989.
- 8. Goekop JG, Carbatt PAT : Treatment of neuroleptic malignant syndrome With danirolene. Lancet 2 ; 49-50, 1982,
- 9. Granato JE, Stern BJ, Ringel A, Karim AH, Krumholz A, Coyle J, Adler S : Neuroleptic malignant syndrome : Succesful treatment with dantrolene and bromo-criptine, Ann Neurol 14 : 89-90, 1983.
- 10.Gronert GA : Malignant hiperthermia. Anestesiology 53 : 355-423, 1980.
- 11.Guze BH, Baxter LR, : Neuroleptiç malignant syndrome, New Eng J 313 : 163-166, 1985.
- 12. Henderson VW, Wooten GF : Neuroleptic malignant syndrome :a pathogenetic role for dopamine receptör blockade, Neurology 31 : 132-137, 1981.
- 13.Krivosic-Horber R, Adnet P, Guevart E, Theunynck D, Lestavel P : Neuroleptic malignant syndrome and malignant hyperthermia. Br J Anaesth 59 : 1554-1556, 1987.
- 14. Lostra F, Linkowicz J : General anesthesia after neuroleptic malignant syndrome. Bial Psychiatr 18 : 243-247, 1983.
- 15.Morris HH, McCormick W, Reinarz JA : Neuroleptic malignant syndrome. Arch Neurol 37 : 462-463, 1980.
- 16. Muellen PS, Vester JW, Fermaglich J : Neuroleptic malignant syndrome. Successful treatmeni, with bromo-criptine. JAMA 249 ; 386-388, 1983.
- 17. Neuroleptic malignant syndrome. Lancet 1 : 545-546, 1984.
- 18. Tulunay M, Anadol E, Saygın B, Yılmaz O, Çanakçı N, Elverdi N, Arsan M: Malignant hyperthermia (Â case report). Türkiye klinikleri Tıp Bilimleri Araştırma Dergisi 5 : 553-558, 1987.
- 19.Weinberg S, Twersky RS : Neuroleptic malignant syndrome. Anesth Analg 62: 845-850, 1983.
- 20. Zubenko G, Pope HG : Management of a case of neuroleptic malignant syndrome with bromocriptine. Am J Psychiatr 140 : 1619-1920, 1983.
Abstract
Neuroleptic malignant syndrome (NMS) is a rare but highly lethal complication of treatment with neuroleptics. NMS is a syndrome characterized by severe extrapyramidal dysfunction, hyperthermia, fluctuations in consciousness, and autonomic disorders due to neuroleptic use. In this article, we present a patient who developed NMS following an injection of haloperidol during anesthesia. General anesthesia was provided in our patient with thiopental, succinylcholine, N:0/0; and halothane. NMS occurred after the administration of anesthesia. It was diagnosed based on the following symptoms: complete tachycardia, hyperpnea, sweating, generalized muscle rigidity, akinesia, hyperthermia, loss of consciousness, and elevated serum creatine phosphokinase (CPK) levels. Treatment consists of cooling, oxygen therapy, volume replacement to prevent renal failure, and forced diuresis. In summary, medical teams using neuroleptics must be alert to the possibility of developing NMS and early diagnosis is essential for successful treatment.
Project Number
-
References
- 1. Baldessarini RS : Drugs and the treatment of psychiatric disorders. In : Gilman AG, Goodmann LS, Rall TW, Murad F, eds. The pharmacological basis of therapeutics,7 th ed. New York, Mc Millan Pub 1985 : 387-445.
- 2. Britt BA, Kalow W : Malignant hyperthermia : A statistical review, Can Anaesth Soc J 17 : 293-315, 1970.
- 3. Burke RE, Fahn S, Mayeux R, Weinberg H, Louis K, Willner JH ; Neurolepticmalignant syndrome caused by dopamine-depleting drugs in a patient withHuntington disease, Neurology (Ny) 31 : 1022 1026, 1981.
- 4,Cremona-Barbaro A : Neuroleptic induced catatonic symptoms. Br J Psyohiairy 142 : 98-99, 1988.
- 5. Daoudal P, Delacour JL : Treatment of neuroleptic malignant syndrome with dantrolene. Lancet 2 : 217, 1982.
- 6.Dhib-Jalbut $, Hesselbrock R, Brott J, Silbergeld b : Treatment of ihe neuroleptic malignant syndrome with bromecriptine, JAMA 250 : 484-485
- 7. Fletcher JE, Rosenberg H, Lizzo FH ; Effects of droperidol, haloperidol and ketamine on halothane, succinylcholine, and caffeine contractures : implications or malignant hyperihermia. Acta Anaesthesiol Scand 33 : 187-192, 1989.
- 8. Goekop JG, Carbatt PAT : Treatment of neuroleptic malignant syndrome With danirolene. Lancet 2 ; 49-50, 1982,
- 9. Granato JE, Stern BJ, Ringel A, Karim AH, Krumholz A, Coyle J, Adler S : Neuroleptic malignant syndrome : Succesful treatment with dantrolene and bromo-criptine, Ann Neurol 14 : 89-90, 1983.
- 10.Gronert GA : Malignant hiperthermia. Anestesiology 53 : 355-423, 1980.
- 11.Guze BH, Baxter LR, : Neuroleptiç malignant syndrome, New Eng J 313 : 163-166, 1985.
- 12. Henderson VW, Wooten GF : Neuroleptic malignant syndrome :a pathogenetic role for dopamine receptör blockade, Neurology 31 : 132-137, 1981.
- 13.Krivosic-Horber R, Adnet P, Guevart E, Theunynck D, Lestavel P : Neuroleptic malignant syndrome and malignant hyperthermia. Br J Anaesth 59 : 1554-1556, 1987.
- 14. Lostra F, Linkowicz J : General anesthesia after neuroleptic malignant syndrome. Bial Psychiatr 18 : 243-247, 1983.
- 15.Morris HH, McCormick W, Reinarz JA : Neuroleptic malignant syndrome. Arch Neurol 37 : 462-463, 1980.
- 16. Muellen PS, Vester JW, Fermaglich J : Neuroleptic malignant syndrome. Successful treatmeni, with bromo-criptine. JAMA 249 ; 386-388, 1983.
- 17. Neuroleptic malignant syndrome. Lancet 1 : 545-546, 1984.
- 18. Tulunay M, Anadol E, Saygın B, Yılmaz O, Çanakçı N, Elverdi N, Arsan M: Malignant hyperthermia (Â case report). Türkiye klinikleri Tıp Bilimleri Araştırma Dergisi 5 : 553-558, 1987.
- 19.Weinberg S, Twersky RS : Neuroleptic malignant syndrome. Anesth Analg 62: 845-850, 1983.
- 20. Zubenko G, Pope HG : Management of a case of neuroleptic malignant syndrome with bromocriptine. Am J Psychiatr 140 : 1619-1920, 1983.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Anaesthesiology |
| Journal Section | Articles |
| Authors | |
| Project Number | - |
| Publication Date | March 31, 1990 |
| Published in Issue | Year 1990 Volume: 43 Issue: 1 |
