Department of Health Sciences, University Magna Graecia of Catanzaro, Italy.
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Italy.
Riv Psichiatr. 2020 Nov-Dec;55(6):366-370. doi: 10.1708/3503.34895.
Postoperative delirium (POD) is a complication that can occur in patients of any age undergoing major surgery. Due to the high incidence of delirium morbidity and mortality, it is important to identify and treat delirium quickly and successfully. Although many organic, surgical and psychiatric risk factors are recognized as putative causes of delirium, heroin withdrawal is not yet well defined and evaluated in the prevention and treatment of POD. We report a case report of a multi-drug addicted patient, without any other psychiatric comorbidity, suffering from heroin-withdrawal POD after urgent major cardiac surgery, successfully treated with clonazepam orally after conventional therapy failure. At the time of discharge, POD was completely solved and without further complications, psychiatric therapy was further reduced just to a low dose of clonazepam and the patient was referred to a specialized drug abuse center. The reported case suggests that clonazepam may be considered a valid option in case of heroin-withdrawal POD after conventional treatments failure.
术后谵妄（POD）是一种可能发生在任何年龄段的接受大手术的患者的并发症。由于谵妄发病率和死亡率高，因此重要的是要快速成功地识别和治疗谵妄。尽管许多有机的、手术的和精神科的危险因素被认为是谵妄的可能原因，但海洛因戒断在 POD 的预防和治疗中尚未得到很好的定义和评估。我们报告了一例多药成瘾患者的病例报告，该患者没有任何其他精神共病，在紧急大心脏手术后出现海洛因戒断 POD，在常规治疗失败后经口服氯硝西泮成功治疗。出院时，POD 完全解决，无进一步并发症，精神科治疗进一步减少到氯硝西泮低剂量，患者被转介到专门的药物滥用中心。所报告的病例表明，在常规治疗失败后出现海洛因戒断 POD 的情况下，氯硝西泮可能被认为是一种有效的选择。
