Yu Byungchul, Lee Ji Yeon, Kim Yong Beom, Park Hee Yeon, Jung Junsu, Jo Youn Yi
Department of Trauma Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
J Trauma Inj. 2023 Sep;36(3):249-252. doi: 10.20408/jti.2022.0048. Epub 2022 Dec 20.
Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7°C after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.
神经阻滞剂恶性综合征(NMS)是一种罕见但致命的疾病,死亡率很高。NMS的特征是精神状态改变、发热、肌阵挛、自主神经功能障碍以及肌酸磷酸激酶升高。其临床表现可能与酒精相关症状、创伤、败血症、术后躁动或恶性高热相混淆。一名69岁戒酒男性患者因多处创伤后肠系膜损伤被送入手术室以排除感染性休克。在给予氟哌啶醇后,他被怀疑患有NMS,体温突然升至41.7°C。麻醉期间进行了积极降温及快速补液。NMS的延迟诊断和治疗会导致灾难性后果。因此,如果患者既往病史不明或出现提示NMS的临床症状,必须考虑早期治疗。