Metoclopramide induced acute dystonia during intravenous patient-controlled analgesia with droperidol

Kotoe Kamata, Emi Takahashi, Nobutada Morioka, Keiko Nakashima, Motoyo Iwade, Makoto Ozaki

研究成果: Article査読


A patient developed acute dystonia following intravenous administration of metocroplamide 20 mg. A 34-year-old woman underwent right hepatectomy, under general anesthesia managed with desflurane, remifentanil, and rocuronium. At the start of surgery, droperidol 1.5 mg was given intravenously for antiemetic prophylaxis. Operation was completed uneventfully. Intravenous patient-controlled analgesia (iv-PCA) with fentanyl, containing droperidol, was selected for postoperative pain management. The patient showed a reasonable postoperative course; however, around 15 hours post-operatively, she complained of nausea, although droperidol 2.625 mg had been administrated (maximum dose). Nausea subsequently disappeared following intravenous metocroplamide 20 mg, and iv-PCA was terminated. The patient gradually complained of excessive sleepiness. Finally, she showed akinesis and bilateral oculomotor disturbance 140 minutes after metocroplamide administration. However, her vital signs remained stable. Examinations including magnetic resonance imaging, electroencephalogram, and blood test did not show abnormalities. She was diagnosed with acute dystonia She recovered without medications 300 minutes after the onset of akinesis. She could communicate with her eyes, opening/closing, throughout this episode. The effects of antiemetics acting on different receptors are additive. However, we should remember that coadministration of metocroplamide and butyrophenone induces extrapyramidal signs like acute dystonia Intraoperative management extending beyond postoperative antiemetic therapy is necessary.

ジャーナルJapanese Journal of Anesthesiology
出版ステータスPublished - 2015 10

ASJC Scopus subject areas

  • 麻酔学および疼痛医療


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