Serotonin Syndrome in the Operating Room Following Use of Fentanyl in a Patient on a Monoamine Oxidase Inhibitor

Authors

Frass Ahmed
Rania Fardous, Corewell Health East Resident
Roy Soto, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-11-2025

Abstract

A 62-year-old male with treatment-resistant depression managed with phenelzine presented for elective laparoscopic cholecystectomy. Intraoperatively, after receiving fentanyl and sevoflurane, he developed sudden hypertension (210/115 mmHg), tachycardia (130 bpm), hyperthermia (39.2°C), and generalized muscle rigidity. Serotonin syndrome was suspected; sevoflurane was discontinued, midazolam was administered, and active cooling was initiated. The patient was stabilized over the following hour before being transferred to the ICU. This case highlights the importance of perioperative recognition of serotonin syndrome in patients on monoamine oxidase inhibitors and explores prevention and intraoperative management strategies.

Comments

American Society of Anesthesiologists Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX

Recommended Citation

Ahmed F, Fardous R, Soto R. Serotonin syndrome in the operating room following use of fentanyl in a patient on a monoamine oxidase inhibitor. Presented at: American Society of Anesthesiologists Anesthesiology Annual Meeting; 2025 Oct 11; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/8061