수면 무호흡증이 있는 양극성 장애 환자에서 급속 정온요법으로 인해 발생한 급성 호흡 장애

Acute Respiratory Distress due to Rapid Tranquilization in a Bipolar Patient with Sleep Apnea

  • 함병주 (고려대학교 의과대학 신경정신과학교실) ;
  • 서용진 (고려대학교 의과대학 신경정신과학교실) ;
  • 김린 (고려대학교 의과대학 신경정신과학교실)
  • Ham, Byung-Joo (Department of Neuropsychiatry, Korea University, College of Medicine) ;
  • Seo, Yong-Jin (Department of Neuropsychiatry, Korea University, College of Medicine) ;
  • Kim, Leen (Department of Neuropsychiatry, Korea University, College of Medicine)
  • 발행 : 2001.12.30

초록

Chemical restraint or "rapid tranquilization" is another option in treating patients who are a danger to themselves or others and struggle violently once physically restrained. The most commonly used drugs are benzodiazepines and antipsychotics. The use of benzodiazepines, either alone or in combination with high potency neuroleptics, has increased in recent years. Benzodiazepines are extremely safe but may cause respiratory depression and hypotension. Respiratory depression is more likely with intravenous administration, therefore these medications should be given slowly and titrated to the desired effect. Special care should be taken when sedating patients who are under the influence of alcohol or narcotics and are sleep apneic patients. This report deals with a case of respiratory distress in a patient with sleep apnea syndrome after the rapid tranqulization. All patients receiving chemical restraint must be carefully monitored. For critically ill patients who require sedation or chemical restraint, the constant attendance of a physician may be warranted.

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