Postoperative rhabdomyolysis due to neuroleptic malignant syndrome associated with droperidol and metoclopramide

Neuroleptic malignant syndrome (NMS) is a complication of neuroleptics that can rarely occur per operatively. A female patient, 28 years old, ASA I, was admitted for bilateral mammoplasty with breast implant. During the procedure, under sedation and thoracic epidural, she received droperidol and met...

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Bibliographic Details
Authors: Silva, Helga Cristina Almeida da [UNIFESP], Orfali, Guilherme di Camillo [UNIFESP], Machado, Henrique Louzan [UNIFESP], Andrade, Pamela Vieira [UNIFESP], Santos, Joilson Moura [UNIFESP], Silva, Mary dos Santos [UNIFESP], Amaral, José Luiz Gomes do [UNIFESP]
Format: article
Status:Published version
Publication Date:2023
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/70718
Online Access:https://www.termedia.pl/Postoperative-rhabdomyolysis-due-to-neuroleptic-malignant-syndrome-associated-with-droperidol-and-metoclopramide,118,51786,1,1.html
https://repositorio.unifesp.br/handle/11600/70718
https://doi.org/10.5114/ait.2023.132910
Access Level:Open access
Keyword:Neuroleptic malignant syndrome
Anaesthesia
Droperidol
Metoclopramide
Description
Summary:Neuroleptic malignant syndrome (NMS) is a complication of neuroleptics that can rarely occur per operatively. A female patient, 28 years old, ASA I, was admitted for bilateral mammoplasty with breast implant. During the procedure, under sedation and thoracic epidural, she received droperidol and metoclopramide. After two hours, she evolved with myalgia, tachycardia, tachypnea, hyperthermia, and increased creatine kinase (CK) levels (9,702 IU/L). After supportive therapy, there was a complete improvement. A further extensive investigation with physical/neurological examination, baseline serum CK level, and electroneuromyography was normal. Molecular study for myopathies did not detect any pathogenic variant and the in vitro muscle contracture test for malignant hyperthermia was negative. Diagnosis of exclusion of NMS was performed. The anaesthesiologist must recognize NMS manifestations, allowing early treatment.

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