Postoperative Serotonin Syndrome Following Methylene Blue Administration for Vasoplegia After Cardiac Surgery: A Case Report and Review of the Literature.

Abstract

Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system. The increasing incidence of this condition is thought to parallel the increasing use of serotonergic agents in medical practice. The selective serotonin reuptake inhibitors are perhaps the most commonly implicated group of medications associated with serotonin syndrome. This case report describes the occurrence of postoperative serotonin syndrome in a patient on long-term sertraline who underwent coronary artery bypass graft and was treated with methylene blue for perioperative vasoplegia. It delineates the various clinical features commonly encountered and illustrates the recommended management modalities, including prevention, for this potentially lethal medical emergency. With prompt diagnosis and expeditious treatment, the patient has had full recovery.

• Authors: Mafdy N Basta
• Journal: Seminars in cardiothoracic and vascular anesthesia (Semin Cardiothorac Vasc Anesth) Vol. 25 Issue 1 Pg. 51-56 (Mar 2021) ISSN: 1940-5596 [Electronic] United States
• PMID: 32951524 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Enzyme Inhibitors
• Hypnotics and Sedatives
• Neuromuscular Nondepolarizing Agents
• Serotonin Antagonists
• Cyproheptadine
• Lorazepam
• Methylene Blue
• Rocuronium

Topics

• Cardiac Surgical Procedures
• Cyproheptadine (therapeutic use)
• Enzyme Inhibitors (adverse effects, therapeutic use)
• Humans
• Hypnotics and Sedatives (therapeutic use)
• Lorazepam (therapeutic use)
• Male
• Methylene Blue (adverse effects, therapeutic use)
• Middle Aged
• Neuromuscular Nondepolarizing Agents (therapeutic use)
• Postoperative Complications (chemically induced, drug therapy)
• Rocuronium (therapeutic use)
• Serotonin Antagonists (therapeutic use)
• Serotonin Syndrome (chemically induced, drug therapy)
• Vasoplegia (drug therapy)