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[Repeated convulsions after abrupt benzodiazepine withdrawal]
M Chapillon1, A Fosse, P Grison
1Département d'Anesthésie-Réanimation, CHR, Angers.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1987
Summary
Abrupt benzodiazepine withdrawal after anesthesia can cause serious complications like seizures and cardiac arrest. Physicians must inquire about patient drug use, especially before surgery, to prevent these severe withdrawal syndromes.
Area of Science:
- Anesthesiology
- Pharmacology
- Neurology
Background:
- Benzodiazepines are commonly prescribed for their safety profile.
- Abrupt cessation of benzodiazepines can precipitate withdrawal syndromes.
- General anesthesia can increase the risk of unrecognized benzodiazepine withdrawal.
Observation:
- A patient undergoing vascular surgery experienced severe benzodiazepine withdrawal.
- Symptoms included recurrent epileptic seizures and transient cardiac arrest.
- The patient had a history of high-dose, non-prescribed benzodiazepine use.
Findings:
- Withdrawal symptoms ceased upon re-administration of benzodiazepines.
- The exact neurobiological mechanisms of benzodiazepine withdrawal remain unclear.
- Risk factors for severe withdrawal include dose, duration, and abruptness of cessation.
Implications:
- Anesthesiologists must be vigilant for potential benzodiazepine withdrawal.
- Thorough pre-anesthetic patient interviews are crucial for identifying drug intake.
- Preventing severe withdrawal necessitates awareness of patient's benzodiazepine use history.