Serotonin syndrome precipitated by fentanyl during procedural sedation.
Fentanyl is frequently used for analgesia during emergency procedures. We present the cases of 2 patients who developed agitation and delirium after intravenous fentanyl administration. These patients were chronically taking selective serotonin reuptake inhibitors (SSRIs). Both developed neuromuscular examinations consistent with serotonin syndrome, a diagnosis that must be established on the basis of clinical criteria. Although they required aggressive supportive care, including mechanical ventilation, both patients made a full recovery. Use of fentanyl for procedural sedation may precipitate serotonin syndrome in patients taking SSRIs or other serotonergic drugs.
Kirschner
Ron
R
PinnacleHealth Toxicology Center, Pennsylvania State University Toxicology Fellowship, Harrisburg, Pennsylvania, USA.
Donovan
J Ward
JW