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DAFTAR PUSTAKA

1. Paitl FV. Diakses http://www.joacp.org/article.asp?issn=0970-

91!"#ear=$01$"%ol&'e=$"iss&e=("spage=!17"epage=!19"a&last=)'*&l

kar. +anggal $ 'aret $01,$. o'es D .Diakses http://archi%e.isp&*.co'/jo&rnal/the-internet-jo&rnal-o-

anesthesiolog#/%ol&'e-,0-n&'*er-,/ne&roleptic-'alignant-s#nro'e-&ring-

'itral-%al%e-replace'ent-s&rger#-consierations-in-iagnosis-an-'ana.

+anggal $ 'aret $01,,. icjik 2.Diakses http://www.&ptoate.co'/contents/ne&roleptic-'alignant-

s#nro'e +anggal $ 'aret $01,(. Jeffrey R. Strawn, MD, Paul E. Keck, Jr, MD, Stanley N. Caroff, MD. Diakses

http://ps#chiatr#online.org/ata/3o&rnals/)3P/,1/07aj070.PDF. +anggal $

'aret $01,!. 4ohen D an 5ristow . 3o&rnal 6e&roleptik 'alignant s#nro'. Diakses

http://scholar.google.co'/scholar?=8ohenDan5ristow.

3o&rnal6e&roleptic'alignants#nro'ehl=ias;st=0as;%is=1oi=scholartsa=&1)nr@grA@8)%e=088w@g@w)) .

+anggal $ 'aret $01,B. 5ottoni +6. Diakses

http://www.hospitalph#sician.co'/p/hp;'ar0$;*rie.p . +anggal $ 'aret

$01,.7. 4aplan CA Eaock 53 re* 3). Sinopsis Psikiatri. jili $. $010. +angerang :

5inap&ra aksara. p. !$- ,. &sli' . Pan&an Praktis Pengg&naan 4linis G*at Psikotropik. 2isi ke ,.

$007. 3akarta: P+ 6&h ja#a. p. $$- $,9. A*rahi' E). Psikoar'ako. Psikiatri. 2isi 1 $011. +angerang : 3elajah

6&santara. Cal 119- 1$(10. Neuroleptic malignant syndrome From Wikipedia. Diakses

http://en.wikipeia.org/wiki/6e&roleptic;'alignant;s#nro'e. +anggal $

'aret $01,11.Assel*acher 43. Al'& Pen#akit ala'. 2isi !. $00B. og#akarta: ni%ersitas

ajah 'aa. Cal $7$9-$7,0.12.Hammergren DJ. NEUROLEP!" #$L!%N$N &'NDRO#E. Diakses

http://www.nursing.arizona.edu/Library/HAMME!E"#$.P$%. +anggal $

'aret $01,.

http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkarhttp://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkarhttp://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkarhttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://www.uptodate.com/contents/neuroleptic-malignant-syndromehttp://www.uptodate.com/contents/neuroleptic-malignant-syndromehttp://psychiatryonline.org/data/Journals/AJP/3818/07aj0870.PDFhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://www.hospitalphysician.com/pdf/hp_mar02_brief.pdfhttp://en.wikipedia.org/wiki/Neuroleptic_malignant_syndromehttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://archive.ispub.com/journal/the-internet-journal-of-anesthesiology/volume-30-number-3/neuroleptic-malignant-syndrome-during-mitral-valve-replacement-surgery-considerations-in-diagnosis-and-manahttp://www.uptodate.com/contents/neuroleptic-malignant-syndromehttp://www.uptodate.com/contents/neuroleptic-malignant-syndromehttp://psychiatryonline.org/data/Journals/AJP/3818/07aj0870.PDFhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://scholar.google.com/scholar?q=Cohen+D+and+Bristow+M.+Journal+Neuroleptic+malignant+syndrome&hl=id&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=JUdlUZu1AYnqrQfgrIGQCA&ved=0CCwQgQMwAAhttp://www.hospitalphysician.com/pdf/hp_mar02_brief.pdfhttp://en.wikipedia.org/wiki/Neuroleptic_malignant_syndromehttp://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkarhttp://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkarhttp://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=4;spage=517;epage=519;aulast=Ambulkar


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+he Anternet 3o&rnal o )nesthesiolog# AEE6: 109$-(0B<

6e&roleptic alignant E#nro'e D&ring itral Val%e eplace'ent E&rger#: 8onsierations An

Diagnosis )n anage'ent

Cenr# Hi& .D. Depart'ent o )nesthesiolog# Di%ision o 8ariothoracic )nesthesia +&lane

ni%ersit# Cospitals )n 8linics 6ew Grleans Ho&isiana

&antiago %ome( #.D. Department o) $nest*esiology+ Di,ision o) "ardiot*oracic $nest*esia+ ulane Uni,ersity

Hospitals $nd "linics Ne- Orleans+ Louisiana

Francis $. Rosinia #.D. Department o) $nest*esiology+ Di,ision o) "ardiot*oracic $nest*esia+ ulane Uni,ersity

Hospitals $nd "linics Ne- Orleans+ Louisiana

Citation: H. Liu + &. %ome( + F.$. Rosinia Neuroleptic #alignant &yndrome During #itral /al,e Replacement

&urgery "onsiderations !n Diagnosis $nd #anagement. The Internet Journal of Anesthesiology. 0120 /olume 31

Num4er 3. DO! 21.556170c34

$4stract

Neuroleptic malignant syndrome 8N#&9 is an unusual idiosyncratic syndrome due to central dopaminergic

antagonism or de)iciency. !t -as rarely reported a)ter or during cardiac surgery. Here -e report a :; years old )emale

-*o -as on dual N#& suc* as re-arming process+ meta4olic acidosis+ *emodynamic insta4ilities+

dysr*yt*mias and *ypercarnia can mimic t*e )eatures o) N#&. #aintaining a *ig* inde= o) suspicion i) t*e patient

*ad a *istory o) psyc*iatric disorder and7or used antipsyc*otic medications preoperati,ely may )acilitate early

diagnosis and timely management -it* dantrolene and ot*er systemic measures.

!ntroduction

Neuroleptic malignant syndrome 8N#&9 is a rare+ idiosyncraticand potentially li)e


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immediately initiated. *e patient sur,i,ed t*e surgery and t*e episode o) intraoperati,e N#&. *e implications )or

t*e diagnosis and management o) N#& during surgery+ especially during ,al,ular cardiac surgery in,ol,ing

cardiopulmonary 4ypass and arti)icial re-arming processes+ are discussed.

.Discussion

Neuroleptic malignant syndrome 8N#&9 is a potentially li)e% ?B@ ?6@?22@. For

cardiacanest*esia pro,iders+ N#& poses speci)ic c*allenges *ere is a re-arming process -*en -eaning o)) "P>+

so a temperature escalating process normally e=ists+ t*is may delay t*e diagnosis >lood pressure )luctuations can

occur )reuently immediately a)ter -eaning o)) "P> "ardiac dysr*yt*mia is not unusual in many patients Iust

coming o)) "P> #ild meta4olic acidosis sometimes e=ists a)ter -eaning o)) "P>+ -*ic* may mimic t*e meta4olic


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status o) N#& and under general anest*esia )or cardiac surgery+ t*e muscle rigidity indicati,e o) N#& is usually

antagoni(ed 4y t*e anest*esiaGs non

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