Successful management of delirium with dexmedetomidine in a patient with haloperidol-induced neuroleptic malignant syndrome: A case report

Yang, Chenghui; Chiu, Ching-Tang; Yeh, Yu-Chang; Chao, Anne

doi:10.12998/wjcc.v10.i2.625

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…In addition, DEX usage might ameliorate behavioral turbulences, such as an attack, anxiety, and cognitive dysfunction [14]. Moreover, several reports have suggested DEX has anesthetic, minor tranquilizer, and antidelirium properties without agitation [15]. ese characteristics make it a proper selection for sedation in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Dexmedetomidine on Postoperative Delirium and Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Lobectomy

Zhao

Wang

Ding

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of dexmedetomidine on postoperative cognitive function and delirium in elderly patients undergoing thoracoscopic lobectomy. Methods. 109 elderly patients (age is more than 65 years) who underwent thoracoscopic lobectomy in our hospital from June 2020 to Feb 2022 were randomly divided into the dexmedetomidine (DEX) group (n = 54) and the control group (n = 55). The patients in the experimental group were given dexmedetomidine by intravenous pump, intravenous pump 0.5 μg/kg within 10 minutes, and maintained the speed of 0.5 μg/(kg. h) to 30 min before the operation was ended. The control group was given the same amount of normal saline. Delirium assessment-severity (CAM-S) assessment and Mini-Cog were used to assess the severity levels of POD and POCD 24 h before, 6 hours after, one day after the operation, three days after the operation, and 1 week after the operation. Serum TNF-αα and NSE levels were assessed by using enzyme-linked immunosorbent assay. NRS pain marks were assessed in the DEX group at postanesthesia care unit (PACU) and 24 postoperation. Surgical pierhysmographic index (SPI) evaluation was performed at five time points. Results. The Mini-Cog scores in the DEX group were markedly enhanced compared with those in the saline group 6 and 24 hours after the operation. The SPI values in the DEX group were markedly reduced within 2 min after intubation and at surgical sutures. Moreover, the CAM scores in the DEX group were markedly reduced 24 hours after the operation. Tumor necrosis factor-α (TNF-α) and neuron-specific enolase (NSE) levels were significantly decreased in the DEX group at T1∼T3. Conclusion. The use of dexmedetomidine in the thoracoscopic lobectomy in elderly patients could reduce the occurrence and severity of postoperative cognitive dysfunction and delirium.

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Section: Introductionmentioning

confidence: 99%

Prevention of Dexmedetomidine on Postoperative Delirium and Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Lobectomy

Zhao

Wang

Ding

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…We performed a review of NMS case reports from clinicians other than psychiatrists in English and Japanese literature. They could be classified into two groups: (1) cases in which NMS onset was triggered by administering causative drugs 17–19,22–89 and (2) cases in which NMS developed from disruption of regular medication (Tables 7 and 8). 8,16,90–114 An example of the former is a case in which antipsychotic drugs were administered for postoperative delirium; an example of the latter is a case in which regular medication (i.e., antipsychotic drugs) to treat schizophrenia was discontinued temporarily because of general anesthesia.…”

Section: Occurrences Of Nms In Fields Other Than Psychiatrymentioning

confidence: 99%

“…The major reason for drug administration was postoperative restlessness, 18,19,25,27,28,30–34,36–39,44,46,52–55,57–59,61–64,67–70,72,75,78,81,84,86,89 followed by nausea 19,22,24,33,42,51,55,59,61,73,80,86 and delirium 35,40,49,56,71,72,74,82,87,88 (Table 10). Haloperidol caused the highest number of NMS cases, 17–19,25–33,35–40,44,46,53–59,61–64,67,69,74–76,81,82,86,87,89 followed by metoclopramide, 19,24,42,55,60,73,77,86 quetiapine, 52,56,70–72 droperidol, 33,34,51,61 and risperidone 41,52,72,84 (Table 11). Although the results indicated that haloperidol was the drug most commonly used to cure postoperative delirium, statistical analysis is needed to determine whether haloperidol is a significant cause of NMS.…”

Section: Occurrences Of Nms In Fields Other Than Psychiatrymentioning

confidence: 99%

“…Primary conditions in the first group ranged, widely, including trauma, 19,26,27,29,32,34,[40][41][42]52,57,58,64,75,81,83,86,88,89 digestive disease, 25,30,36,37,43,45,46,54,59,60,65,66,77,80,87 malignant tumor, 18,23,24,31,33,35,38,47,51,61,63 and cardiovascular disease 28,39,44,50,53,55,56,…”

Section: Occurrences Of Nms In Fields Other Than Psychiatrymentioning

confidence: 99%

“…The physical conditions of trauma patients were relatively severe compared with those with other diseases. The major reason for drug administration was postoperative restlessness, 18,19,25,27,28,30–34,36–39,44,46,52–55,57–59,61–64,67–70,72,75,78,81,84,86,89 followed by nausea 19,22,24,33,42,51,55,59,61,73,80,86 and delirium 35,40,49,56,71,72,74,82,87,88 (Table 10). Haloperidol caused the highest number of NMS cases, 17–19,25–33,35–40,44,46,53–59,61–64,67,69,74–76,81,82,86,87,89 followed by metoclopramide, 19,24,42,55,60,73,77,86 quetiapine, 52,56,70–72 droperidol, 33,34,51,61 and risperidone 41,52,72,84 (Table 11).…”

Section: Occurrences Of Nms In Fields Other Than Psychiatrymentioning

confidence: 99%

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Neuroleptic malignant syndrome in fields other than psychiatry

Shimada

Kase

Nakatsuru

et al. 2023

Oral Science International

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Neuroleptic malignant syndrome (NMS) is an adverse effect of drugs, mainly neuroleptics. It is characterized by problems related to the autonomic nervous system (such as hyperthermia, diaphoresis, and tachycardia) and extrapyramidal symptoms (such as muscle rigidity and tremor). After onset, NMS progresses rapidly and without treatment, becomes life‐threatening. In recent years, NMS has become better recognized, and treatment has improved; most cases are now curable before becoming dangerous. Most NMS reports are from psychiatrists or neurologists; few are from other specialized clinicians. However, nonpsychiatric clinicians, such as surgeons, emergency physicians, orthopedists, and oral surgeons, sometimes must administer neuroleptic drugs. Although NMS is rare, its effects on patients may be debilitating, and this places a heavy burden on clinicians. Thus, not only psychiatrists but also clinicians in various other fields should understand this illness. This article describes NMS in fields other than psychiatry and its diagnosis, risk factors, and treatment strategies.

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Haloperidol/lorazepam

2022

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Successful management of delirium with dexmedetomidine in a patient with haloperidol-induced neuroleptic malignant syndrome: A case report

Cited by 4 publications

References 16 publications

Prevention of Dexmedetomidine on Postoperative Delirium and Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Lobectomy

Prevention of Dexmedetomidine on Postoperative Delirium and Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Thoracoscopic Lobectomy

Neuroleptic malignant syndrome in fields other than psychiatry

Haloperidol/lorazepam

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