Repeated use of propofol and vecuronium appears safe for anesthesia in patients with a history of neuroleptic malignant syndrome undergoing electroconvulsive therapy.
Supports cautious propofol-vecuronium use for repeated ECT in NMS; hypothesis-generating and requires prospective confirmation.
Neuroleptic malignant syndrome (NMS) is the most serious side effect produced by the administration of antipsychotic drugs. NMS shares many clinical similarities with malignant hyperthermia (MH), but the etiology of NMS and the relation between NMS and MH remain unknown. Anesthetic regimens for patients with NMS are not well established. We gave repeated anesthesia to a patient with a history of NMS undergoing electroconvulsive therapy for the treatment of depression. Propofol and vecuronium were used in twelve consecutive ECT sessions without complications. In this case report, we describe the safe and satisfactory repeated use of propofol in a patient with a history of NMS, and outline NMS and its questionable relation to MH.
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Sakamoto et al. (1999) studied this question.
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