A case of postoperative serotonin syndrome following the administration of fentanyl, palonosetron, and meperidine: A case report

Lee, Chiu; Kim, Eun Ju; Joe, Soohyun; Ban, Jong Seouk; Lee, Ji Hyang; An, Ji Hyun

doi:2015.10.4.267

Anesth Pain Med > Volume 10(4); 2015 > Article

Case Report

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2015;10(4):267-270.
DOI: https://doi.org/10.17085/apm.2015.10.4.267 Published online October 31, 2015.

A case of postoperative serotonin syndrome following the administration of fentanyl, palonosetron, and meperidine: A case report

Chiu Lee, Eun Ju Kim, Soohyun Joe, Jong Seouk Ban, Ji Hyang Lee, Ji Hyun An

¹Department of Anesthesiology and Pain Medicine, Daegu Fatima Hospital, Daegu, Korea. kej1127@fatima.or.kr
²Department of Psychiatry, Ulsan University Hospital, Ulsan, Korea.

Received: 28 April 2015 • Revised: 1 July 2015 • Accepted: 8 July 2015

Abstract

Serotonin syndrome is an unexpected adverse reaction of serotonergic medication. Some drugs used by anesthesiologists may cause serotonin syndrome. Serotonin syndrome is known to be related to 5-hydroxytryptamine 1A and 5-hydroxytryptamine 2A agonism. However, recent research has revealed evidence that 5-hydroxytryptamine 3 (5-HT3) antagonism can also play a role in serotonin syndrome. Among the 5-HT3 antagonists, palonosetron is the most highly specific. In this study, we present the first case of fentanyl- and meperidine-induced serotonin syndrome precipitated by palonosetron in general anesthesia.

Key Words: Fentanyl, Meperidine, Palonosetron, Serotonin, Serotonin syndrome