Kirschner Ron, Donovan J Ward
PinnacleHealth Toxicology Center, Pennsylvania State University Toxicology Fellowship, Harrisburg, Pennsylvania, USA.
J Emerg Med. 2010 May;38(4):477-80. doi: 10.1016/j.jemermed.2008.01.003. Epub 2008 Aug 30.
Fentanyl is frequently used for analgesia during emergency procedures. We present the cases of 2 patients who developed agitation and delirium after intravenous fentanyl administration. These patients were chronically taking selective serotonin reuptake inhibitors (SSRIs). Both developed neuromuscular examinations consistent with serotonin syndrome, a diagnosis that must be established on the basis of clinical criteria. Although they required aggressive supportive care, including mechanical ventilation, both patients made a full recovery. Use of fentanyl for procedural sedation may precipitate serotonin syndrome in patients taking SSRIs or other serotonergic drugs.
芬太尼常用于急诊手术中的镇痛。我们报告了2例静脉注射芬太尼后出现躁动和谵妄的病例。这些患者长期服用选择性5-羟色胺再摄取抑制剂（SSRI）。两人的神经肌肉检查结果均符合5-羟色胺综合征，该诊断必须根据临床标准来确立。尽管他们需要积极的支持治疗，包括机械通气，但两名患者均完全康复。在服用SSRI或其他5-羟色胺能药物的患者中，使用芬太尼进行程序性镇静可能会引发5-羟色胺综合征。
