Beatty Nicole C, Nicholson Wayne T, Langman Loralie J, Curry Timothy B, Eisenach John H
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
J Clin Anesth. 2013 Dec;25(8):662-5. doi: 10.1016/j.jclinane.2013.06.005. Epub 2013 Oct 1.
Serotonin syndrome is gaining attention in perioperative and chronic pain settings due to the growing prevalence of multimodal therapies that increase serotonin levels and thereby heighten patient risk. A patient's genetic make-up may further increase the risk of serotonin syndrome. A case of serotonin syndrome on emergence after general anesthesia is presented. A subsequent cytochrome P4502D6 genetic test result suggested a potential alteration in metabolism. For this patient, who was taking combination antidepressant medications and receiving common perioperative medicines, additive pharmacodynamic effects converged with a pharmacogenetic predisposition, resulting in serotonin syndrome.
由于增加血清素水平从而提高患者风险的多模式疗法的日益普及，血清素综合征在围手术期和慢性疼痛环境中越来越受到关注。患者的基因构成可能会进一步增加血清素综合征的风险。本文介绍了一例全身麻醉后苏醒期发生血清素综合征的病例。随后的细胞色素P4502D6基因检测结果提示代谢可能存在改变。对于该正在服用联合抗抑郁药物并接受常见围手术期药物治疗的患者，相加的药效学效应与药物遗传学易感性共同作用，导致了血清素综合征。
