• J Emerg Med · May 2010

    Case Reports

    Serotonin syndrome precipitated by fentanyl during procedural sedation.

    • Ron Kirschner and J Ward Donovan.
    • PinnacleHealth Toxicology Center, Pennsylvania State University Toxicology Fellowship, Harrisburg, Pennsylvania, USA.
    • J Emerg Med. 2010 May 1;38(4):477-80.

    AbstractFentanyl is frequently used for analgesia during emergency procedures. We present the cases of 2 patients who developed agitation and delirium after intravenous fentanyl administration. These patients were chronically taking selective serotonin reuptake inhibitors (SSRIs). Both developed neuromuscular examinations consistent with serotonin syndrome, a diagnosis that must be established on the basis of clinical criteria. Although they required aggressive supportive care, including mechanical ventilation, both patients made a full recovery. Use of fentanyl for procedural sedation may precipitate serotonin syndrome in patients taking SSRIs or other serotonergic drugs.Copyright (c) 2010 Elsevier Inc. All rights reserved.

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