[Drug-induced laryngospasm].
We report a case of drug-induced laryngospasm due to Chlorpromazine. A drug-induced laryngospasm has not been previously reported in the literature. A 70-year-old male with the proximal end fracture of the femur was scheduled for the operative fixation. He had a past history of alcoholism and had underwent a long-term chlorpromazine therapy for 45 years until admission to our hospital. There have been a few reports on unexplained sudden deaths of patients receiving long-term treatment with chlorpromazine. Caution was therefore needed in general anesthesia, which was thought to be safer than epidural or spinal anesthesia in this case. Accordingly for the preparation of an emergency operation, the central venous catheterization via the internal jugular vein was performed under subcutaneous injection of lidocaine. Severe dyspnea and cyanosis occurred a few minutes after the administration of lidocaine. The specific diagnosis of laryngospasm was made by inspection of the vocal cords. Immediate oral intubation was performed and no complications ensued during and after the operation. This episode strongly suggests that one reason of the unexplained sudden deaths of patients receiving long term treatment with chlorpromazine could be laryngospasm. In conclusion, anesthesiologists should be aware of the possibility of laryngospasm under similar conditions.
Nishikawa
T
T
Department of Internal Medicine, CONFORT Hospital, Yokohama.
Munakata
K
K
D000368:Aged; D000768:Anesthesia, General; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002746:Chlorpromazine / Q000009:adverse effects*; D005264:Femoral Fractures / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced*; D007826:Laryngismus / Q000139:chemically induced*; D008297:Male
D014150:Antipsychotic Agents; D002746:Chlorpromazine