Risperidone in a child with untractable emergency delirium: a case report

Korean J Anesthesiol. 2016 Dec;69(6):623-626. doi: 10.4097/kjae.2016.69.6.623. Epub 2016 Sep 8.

Abstract

A 6-year-old boy was scheduled for thoracic magnetic resonance imaging under deep sedation with midazolam 1.8 mg and propofol 100 µg/kg/min via intravenous injection. He showed emergence delirium in the post-anesthesia care unit. The staff attempted to calm him by administering flumazenil as an antidote for midazolam, propofol for further sedation, and meperidine. However, this was not successful. A psychiatrist recommended the use of antipsychotics. Administration of risperidone led to immediate resolution of the boy's symptoms and relaxed him. The use of antipsychotic drugs is not common for anesthesiologists, but should be considered for treating uncontrolled emergence delirium after anesthesia.

Keywords: Antipsychotic drugs; Emergence delirium; Flumazenil; Midazolam; Risperidone.