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

作　　者：Chi-Ju Yang Ching-Tang Chiu Yu-Chang Yeh Anne Chao 

机构地区：[1]Department of Pharmacy,National Taiwan University Hospital,Taipei 100220,Taiwan [2]Department of Anesthesiology,National Taiwan University Hospital,Taipei 100220,Taiwan

出　　处：《World Journal of Clinical Cases》2022年第2期625-630,共6页世界临床病例杂志

基　　金：Supported by National Taiwan University Hospital Fund,No.MS 213.

摘　　要：BACKGROUND We report a case of lorazepam-induced agitated delirium treated with haloperidol,which in turn triggered the onset of neuroleptic malignant syndrome(NMS).The latter condition,a medical emergency,was effectively treated with medical treatment and dexmedetomidine,a versatile and highly selective shortacting alpha-2 adrenergic agonist with sedative-hypnotic and anxiolytic effects.CASE SUMMARY A 65-year-old man with a history of bipolar disorder presented to the emergency department with severe abdominal discomfort after binge eating.During his hospital stay,he received intravenous lorazepam for insomnia.On the next day,he became delirious and was thus treated with seven doses(5 mg each)of haloperidol over a 48 h period.Signs of NMS(hyperthermia,rigidity,myoclonus of upper limbs,impaired consciousness,tachypnea,and dark urine)became apparent and haloperidol was immediately suspended and brisk diuresis was initiated.On intensive care unit admission,he was confused,disoriented,and markedly agitated.Dexmedetomidine infusion was started with the goal of achieving a Richmond Agitation-Sedation Scale score of-1 or 0.NMS was resolved gradually and the patient stabilized,permitting discontinuation of dexmedetomidine after 3 d.CONCLUSION Dexmedetomidine may be clinically helpful for the management of NMS,most likely because of its sympatholytic activity.

关 键 词：HALOPERIDOL DEXMEDETOMIDINE DELIRIUM Neuroleptic malignant syndrome Alpha-2 adrenergic agonists Case report 

分 类 号：R614[医药卫生—麻醉学]