Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report

Opioid-induced catatonia is underrecognized and poorly understood in the literature. An 81-year-old woman with chronic kidney disease stage III taking sertraline underwent surgery with general anesthesia, receiving fentanyl, hydromorphone, and ketamine. Postoperatively, she was unresponsive, rigid,...

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Detalles Bibliográficos
Autores principales: Ketigian, Laura A., Kidambi, Shantanu S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377245/
https://www.ncbi.nlm.nih.gov/pubmed/37463280
http://dx.doi.org/10.1213/XAA.0000000000001695
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author Ketigian, Laura A.
Kidambi, Shantanu S.
author_facet Ketigian, Laura A.
Kidambi, Shantanu S.
author_sort Ketigian, Laura A.
collection PubMed
description Opioid-induced catatonia is underrecognized and poorly understood in the literature. An 81-year-old woman with chronic kidney disease stage III taking sertraline underwent surgery with general anesthesia, receiving fentanyl, hydromorphone, and ketamine. Postoperatively, she was unresponsive, rigid, and cataleptic with pinpoint pupils. Symptoms resolved with a naloxone infusion suggesting opioid-induced catatonia as the leading diagnosis. Differential diagnoses and etiologies discussed reveal a possible multifactorial catatonia mechanism involving opioids, ketamine, and serotonin. Anesthesiologists should consider these potential interactions when using opioids for management of vulnerable patients.
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spelling pubmed-103772452023-07-29 Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report Ketigian, Laura A. Kidambi, Shantanu S. A A Pract Case Report Opioid-induced catatonia is underrecognized and poorly understood in the literature. An 81-year-old woman with chronic kidney disease stage III taking sertraline underwent surgery with general anesthesia, receiving fentanyl, hydromorphone, and ketamine. Postoperatively, she was unresponsive, rigid, and cataleptic with pinpoint pupils. Symptoms resolved with a naloxone infusion suggesting opioid-induced catatonia as the leading diagnosis. Differential diagnoses and etiologies discussed reveal a possible multifactorial catatonia mechanism involving opioids, ketamine, and serotonin. Anesthesiologists should consider these potential interactions when using opioids for management of vulnerable patients. Lippincott Williams & Wilkins 2023-07-18 /pmc/articles/PMC10377245/ /pubmed/37463280 http://dx.doi.org/10.1213/XAA.0000000000001695 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Anesthesia Research Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Case Report
Ketigian, Laura A.
Kidambi, Shantanu S.
Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title_full Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title_fullStr Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title_full_unstemmed Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title_short Postoperative Catatonia After Fentanyl, Hydromorphone, and Ketamine Administration in a Patient Taking Sertraline: A Case Report
title_sort postoperative catatonia after fentanyl, hydromorphone, and ketamine administration in a patient taking sertraline: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377245/
https://www.ncbi.nlm.nih.gov/pubmed/37463280
http://dx.doi.org/10.1213/XAA.0000000000001695
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