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 

作者机构：Department of PharmacyNational Taiwan University HospitalTaipei 100220Taiwan Department of AnesthesiologyNational Taiwan University HospitalTaipei 100220Taiwan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2022年第10卷第2期

页      面：625-630页

核心收录：

学科分类：1002[医学-临床医学] 100217[医学-麻醉学] 10[医学] 

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

主　　题：Haloperidol Dexmedetomidine Delirium Neuroleptic malignant syndrome Alpha-2 adrenergic agonists Case report 

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 *** SUMMARY A 65-year-old man with a history of bipolar disorder presented to the emergency department with severe abdominal discomfort after binge *** his hospital stay,he received intravenous lorazepam for *** the next day,he became delirious and was thus treated with seven doses(5 mg each)of haloperidol over a 48 h *** 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 *** intensive care unit admission,he was confused,disoriented,and markedly *** infusion was started with the goal of achieving a Richmond Agitation-Sedation Scale score of-1 or *** was resolved gradually and the patient stabilized,permitting discontinuation of dexmedetomidine after 3 *** Dexmedetomidine may be clinically helpful for the management of NMS,most likely because of its sympatholytic activity.