CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0042-1744398
Case Report

A Rare Case of Drug Interaction Presenting as Perioperative Hyperthermia in a Patient Presenting for Neurosurgery

Sapna Suresh
1   Division of Neuroanesthesia, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
,
Ajay P. Hrishi
1   Division of Neuroanesthesia, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
,
Manikandan Sethuraman
1   Division of Neuroanesthesia, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
› Author Affiliations

Abstract

Perioperative hyperthermia has many differential diagnoses. This case report describes the rare causation of perioperative hyperthermia in a patient presenting for epilepsy surgery. The patient had two episodes of hyperthermia, initially post-anesthetic induction and later in the immediate post-operative period. The quest for the etiology sheds light on a rare drug interaction between topiramate, an antiepileptic drug, and glycopyrrolate causing intraoperative hyperthermia. However, the literature has not reported drug interaction between topiramate and glycopyrrolate resulting in perioperative hyperthermia. The combination of a glycopyrrolate-induced rise in temperature and oligohidrosis could have resulted in hyperthermia in our patient. Thus, it is prudent to avoid glycopyrrolate in the perioperative period when patients are on topiramate.



Publication History

Article published online:
05 May 2022

© 2022. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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