과용량의 Risperidone 투여로 발생한 신경이완성 악성 증후군

Neuroleptic malignant syndrome (NMS) is a rare, but potentially fatal idiosyncratic reaction to neuroleptics characterized by muscle rigidity, fever, altered consciousness, autonomic instability, leukocytosis and elevated creatinine phosphokinase level suggesting muscle injury. The incidence of NMS is estimated to be between 0.07 and 2.2% among patients receiving neuroleptics, with a motality of 11%. Although the pathophysiology of NMS is not completely understood, reduced dopaminergic activity secondary to antipsychotic induced dopamine receptor blockage is considered to be the best explanation to date. We experienced NMS in a 22-year-old male with antipsychotic drug intoxication who underwent primary closure of dual, self-inflicted wrist laceration. We recognized as NMS about 30 minutes after induction of general anesthesia. All anesthetics were stopped, and supportive care was performed with management of hyperthermia and fluid. Also, Dantrolene sodium and bromocriptine were administered. The patient recovered without any complication. (Korean J Anesthesiol 2006; 51: 261~6)