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

• Autor(a) principal: Silva, Helga Cristina Almeida da [UNIFESP]
• Data de Publicação: 2023
• Outros Autores: 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]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000dwhm
• Texto Completo: 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
• topic: Neuroleptic malignant syndrome; Anaesthesia; Droperidol; 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 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.