rocuronium and Serotonin-Syndrome

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. The increasing incidence of this condition is thought to parallel the increasing use of serotonergic agents in medical practice. The selective serotonin reuptake inhibitors are perhaps the most commonly implicated group of medications associated with serotonin syndrome. This case report describes the occurrence of postoperative serotonin syndrome in a patient on long-term sertraline who underwent coronary artery bypass graft and was treated with methylene blue for perioperative vasoplegia. It delineates the various clinical features commonly encountered and illustrates the recommended management modalities, including prevention, for this potentially lethal medical emergency. With prompt diagnosis and expeditious treatment, the patient has had full recovery.

Topics: Cardiac Surgical Procedures; Cyproheptadine; Enzyme Inhibitors; Humans; Hypnotics and Sedatives; Lorazepam; Male; Methylene Blue; Middle Aged; Neuromuscular Nondepolarizing Agents; Postoperative Complications; Rocuronium; Serotonin Antagonists; Serotonin Syndrome; Vasoplegia

Topics: Aged; Androstanols; Combined Modality Therapy; Cyclohexanols; Humans; Hypnotics and Sedatives; Male; Monoamine Oxidase Inhibitors; Neuromuscular Nondepolarizing Agents; Propofol; Respiration, Artificial; Rocuronium; Selective Serotonin Reuptake Inhibitors; Serotonin Syndrome; Tranylcypromine; Venlafaxine Hydrochloride